Individual provider Active NPI

Rachel Butts Smith, LCSW

  • Social Worker
  • King, NC
National Provider Identifier
1861937922
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
C011997 Issued in NC
Practice address
932 Meadowbrook Dr
King, NC 27021-8249
Phone
(336) 972-6333
NPI assigned
Dec 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P011171 NC
Clinical Social Worker 1041C0700X C011997 NC
Social Worker 104100000X C011997 NC Primary

Addresses

Primary practice location

932 Meadowbrook Dr
King, NC 27021-8249

Mailing address

932 Meadowbrook Dr
King, NC 27021-8249
Phone (336) 972-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190319000283 NC Practitioner - Clinical Social Worker 8628318235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P011171NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Local Healing Counseling and Wellness, PLLC Social Worker Current Accepting new patients
Certus Psychiatry and Integrated Care PLLC CurrentSince Dec 3, 2019 Accepting new patients

Locations

932 Meadowbrook Dr
King, NC 27021
Phone (336) 972-6333

153 Jefferson Church Rd
King, NC 27021
Phone (336) 692-3545

1255 Creekshire Way
Ste 270
Winston Salem, NC 27103
Phone (336) 701-3111

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": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1861937922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 MEADOWBROOK DR",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218249",
            "telephone_number": "336-972-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 MEADOWBROOK DR",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218249",
            "telephone_number": "336-972-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RACHEL",
        "middle_name": "BUTTS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-28",
        "last_updated": "2021-11-08",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011171",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011997",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "C011997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King, NC

Sources for this page

Verify at the official NPI Registry.