Individual provider Active NPI

Larry L. Smith, LSCSW LCAC

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1841455748
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4190 Issued in KS
Practice address
1037 W Munnell St
Wichita, KS 67213-4542
Phone
(316) 617-2987
NPI assigned
Jul 21, 2008
Last updated
Apr 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X AAPS CERTIFICATION KS
Clinical Social Worker 1041C0700X KS
Clinical Social Worker 1041C0700X 4190 KS Primary

Addresses

Primary practice location

1037 W Munnell St
Wichita, KS 67213-4542

Mailing address

524 N Baehr St
Wichita, KS 67212-2220

Other practice location 1

933 N Topeka St
Wichita, KS 67214-3620
Phone (316) 617-2987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081006000221 KS Practitioner - Clinical Social Worker 0840368759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

933 N Topeka St
Wichita, KS 67214-3620
Phone (316) 617-2987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AAPS CERTIFICATIONKSMDAddiction (Substance Use Disorder) Counselor
4190KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A New Beginning Mental Health Counseling Inc Single Specialty CurrentSince Jan 7, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1841455748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 N BAEHR ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672122220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 W MUNNELL ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672134542",
            "telephone_number": "316-617-2987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "933 N Topeka St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672143620",
            "country_code": "US",
            "telephone_number": "316-617-2987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LARRY",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "LSCSW LCAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "AAPS CERTIFICATION",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.