Mykeia J Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P011797 Issued in NC

Practice address

5809 Departure Dr Ste 106
Raleigh, NC 27616-1936

Phone

(919) 872-6220

NPI assigned

Aug 15, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Carolina Community Support Services, Inc.

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1144524703
  NPD (past)
• Carolina Community Support Services, Inc.

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1912144312
  NPD (past)

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1851817480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180",
            "city": "SOUTHMONT",
            "state": "NC",
            "postal_code": "273510180",
            "telephone_number": "919-627-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5809 DEPARTURE DR STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276161936",
            "telephone_number": "919-872-6220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Andrews Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277052993",
            "country_code": "US",
            "telephone_number": "919-682-5777",
            "fax_number": "919-687-6975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MYKEIA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Smith
• Michael David Smith, MD
• Michelle Diane Smith
• Milton Smith
• Monica Shevock Smith, PA-C
• Nicholas Joseph Smith, LMBT
• Olivia Elizabeth Smith, LCSWA
• Olivia S. Smith, DNP - FNP
• Ommunique Monee Smith
• Pamela Smith, APRN-C

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.