Jennifer Rae Smyth, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801101522 Issued in MI

Practice address

11456 Crestridge CT
Holland, MI 49424-9024

Phone

(773) 540-4908

NPI assigned

May 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621123200000",
    "number": "1992379846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11456 CRESTRIDGE CT",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249024",
            "telephone_number": "773-540-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11456 CRESTRIDGE CT",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249024",
            "telephone_number": "773-540-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-16",
        "last_updated": "2021-05-16",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801101522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "smythjennifer12@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11456 Crestridge Ct",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494249024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shakira Ayana Smith
• Timothy Victor Smith
• Tiwanna Cathleen Smith
• Wiley Smith
• Justin Smyly
• Zane Snarski, LLMSW
• Eric D Snyder, M.D.
• Joshua Snyder
• Kristina Snyder, FNP-C
• Jennifer Lynn Solis, FNP

• Clinical Social Worker in Holland, MI
• Providers in Holland, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2021; 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.