Individual provider Active NPI

Jesse Lynn Smyth-Kauffmann, LCSW

  • Clinical Social Worker
  • Red Bank, NJ
National Provider Identifier
1992077549
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05489500 Issued in NJ
Practice address
103 Maple Ave Ste 201
Red Bank, NJ 07701-1715
Phone
(908) 670-5566
NPI assigned
Jan 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 705768 NJ
Clinical Social Worker 1041C0700X 44SC05489500 NJ Primary

Addresses

Primary practice location

103 Maple Ave Ste 201
Red Bank, NJ 07701-1715

Mailing address

206 Sunnyside Rd
Lincroft, NJ 07738-1109
Phone (908) 670-5566

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
44SC05489500NJMDClinical Social Worker
705768NJMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1327795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1992077549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SUNNYSIDE RD",
            "city": "LINCROFT",
            "state": "NJ",
            "postal_code": "077381109",
            "telephone_number": "908-670-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MAPLE AVE STE 201",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011715",
            "telephone_number": "908-670-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH-KAUFFMANN",
        "first_name": "JESSE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-29",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NJ",
            "license": "705768",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05489500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.