Active NPI
Brandy Rose Smith, MSW, LISW-S
- Clinical Social Worker
- Westerville, OH
National Provider Identifier
1962889709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I1303283
- Practice address
- 700 Brooksedge Blvd
Westerville, OH 43081-2820 - Phone
- (740) 255-1209
- NPI assigned
- Apr 30, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I1303283 | OH | Primary |
Addresses
Primary practice location
700 Brooksedge Blvd
Westerville, OH 43081-2820
Mailing address
11 Hardwoods Dr
Pataskala, OH 43062-7002
Phone (740) 255-1209
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0200375 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I1303283 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Clinical | Current | Accepting new patients |
Locations
20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973
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": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430438400000",
"number": "1962889709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 HARDWOODS DR",
"city": "PATASKALA",
"state": "OH",
"postal_code": "430627002",
"telephone_number": "740-255-1209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 BROOKSEDGE BLVD",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430812820",
"telephone_number": "740-255-1209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "BRANDY",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"credential": "MSW, LISW-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-30",
"last_updated": "2015-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I1303283",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0200375",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.