Individual provider Active NPI

Elise Smithmyer, LICSW

  • Clinical Social Worker
  • Silver Spring, MD
National Provider Identifier
1962835405
Registry record updated Nov 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50079866 Issued in DC
Practice address
12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699
Phone
(240) 780-8884
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2020

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 LC50079866 DC Primary

Addresses

Primary practice location

12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699

Mailing address

12501 Prosperity Dr Ste 310
Silver Spring, MD 20904-1699
Phone (402) 780-8884

Other practice location 1

6325 Woodside Ct Ste 350
Columbia, MD 21046-1042
Phone (410) 910-9660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150803001537 MD Practitioner - Clinical Social Worker 4688988751 Reassigns benefits to 1 organization
I20171130001829 DC Practitioner - Clinical Social Worker 4688988751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychcare Psychological Services LLCGroup PAC ID 2264660133, 19 clinicians

Practice addresses (Care Compare)

12501 Prosperity Dr
Suite 310
Silver Spring, MD 20904-1699
Phone (410) 343-9756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50079866DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychcare Psychological Services, LLC CurrentSince Jul 1, 2015 Accepting new patients

Locations

6325 Woodside Ct
Ste 350
Columbia, MD 21046
Phone 41034397569

104 Church Ln
Ste 101102
Pikesville, MD 21208
Phone (410) 343-9756

104 Church Ln
Ste 101
Pikesville, MD 21208
Phone (410) 343-9756

12501 Prosperity Dr
Ste 310
Silver Spring, MD 20904
Phone (240) 780-8884

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": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1962835405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 310",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041699",
            "telephone_number": "402-780-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 310",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041699",
            "telephone_number": "240-780-8884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6325 Woodside Ct Ste 350",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210461042",
            "country_code": "US",
            "telephone_number": "410-910-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITHMYER",
        "first_name": "ELISE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50079866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.