Jay P Smith, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114923 Issued in MA

Practice address

200 Springs Rd BLDG 78
Bedford, MA 01730-1114

Phone

(781) 687-3108

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1972676211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SPRINGS RD BLDG 78",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301114",
            "telephone_number": "781-687-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SPRINGS RD BLDG 78",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301114",
            "telephone_number": "781-687-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAY",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "213065",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1305638",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avy A Skolnik, PH.D.
• Sleep Health Centers LLC
• Patrick Thomas Slein
• Katharine Smidt, PHD
• Amy Melissa Smith, DNP
• Jessica Smith, LICSW
• Tucker Sweetnam Smith, PSY.D.
• John Gerard Smolinsky, PH.D.
• Gayathri Snell, DDS
• Marylynn Sokolowski, LICSW

• Clinical Social Worker in Bedford, MA
• Providers in Bedford, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.