E. Wade Smith, LCSW, LPC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW - 348 Issued in ID

Practice address

111 E 16TH St
Idaho Falls, ID 83401

Phone

(208) 523-1130

Fax

(208) 529-6501

NPI assigned

Sep 19, 2013

Last updated

Sep 19, 2013By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1871929026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 16TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-523-1130",
            "fax_number": "208-529-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 16TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-523-1130",
            "fax_number": "208-529-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "E.",
        "middle_name": "WADE",
        "credential": "LCSW, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC - 161",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW - 348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carson Smith
• Cathleen Marie Smith, LMT
• Chance Smith
• Charissa Bethe'L Smith, ATC
• Daniel Philip Wiser Smith, D.O.
• Emily Smith, LMSW
• Emily Ricks Smith, LCSW-34678
• Ethan Smith, LMSW
• Golden Thane Smith, O.D.
• Haleigh Smith

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.