Individual provider Active NPI

Stephanie Smith, LCSW

  • Clinical Social Worker
  • Commerce, CA
National Provider Identifier
1932564960
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
91212 Issued in CA
Practice address
1000 Goodrich Blvd
Commerce, CA 90022-5103
Phone
(323) 832-9795
NPI assigned
Dec 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 91212 CA Primary
Mental Health Counselor 101YM0800X ASW 69160 CA

Addresses

Primary practice location

1000 Goodrich Blvd
Commerce, CA 90022-5103

Mailing address

1270 S Alfred St
PO Box 352351
Los Angeles, CA 90035-9998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210702002529 CA Practitioner - Clinical Social Worker 2264834852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW 69160CAMDMental Health Counselor
91212CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Enki Health Services, Inc. Current Accepting new patients

Locations

150 E Olive Ave
Ste 203
Burbank, CA 91502
Phone (818) 973-4899

160 S 7th Ave
La Puente, CA 91746
Phone (626) 961-8971

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1932564960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 S ALFRED ST",
            "address_2": "PO BOX 352351",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900359998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GOODRICH BLVD",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900225103",
            "telephone_number": "323-832-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "91212",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW 69160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, CA

Sources for this page

Verify at the official NPI Registry.