Individual provider Active NPI

Courtney Iesha Smith

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1912414269
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.2504228-TRNE Issued in OH
Practice address
605 S Patterson Blvd
Dayton, OH 45402-2649
Phone
(937) 395-4600
NPI assigned
Jan 9, 2018
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S.2504228-TRNE OH Primary

Addresses

Primary practice location

605 S Patterson Blvd
Dayton, OH 45402-2649

Mailing address

605 S Patterson Blvd
Dayton, OH 45402-2649
Phone (937) 395-4600

Other practice location 1

7941 Castleway Dr
Indianapolis, IN 46250-1953
Phone (317) 726-2121

Other practice location 2

141 W 3rd St
Dayton, OH 45402-1814
Phone (937) 461-5550 ext. 156

Other practice location 3

1 Elizabeth Pl
Dayton, OH 45417-3445
Phone (937) 813-1737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.2504228-TRNEOHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1912414269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S PATTERSON BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022649",
            "telephone_number": "937-395-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S PATTERSON BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022649",
            "telephone_number": "937-395-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7941 Castleway Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462501953",
            "country_code": "US",
            "telephone_number": "317-726-2121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454021814",
            "country_code": "US",
            "telephone_number": "937-461-5550 x156",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Elizabeth Pl",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454173445",
            "country_code": "US",
            "telephone_number": "937-813-1737",
            "fax_number": "937-949-7497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COURTNEY",
        "middle_name": "IESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-09",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2504228-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.