Active NPI
Celes Smith, LCSW
- Clinical Social Worker
- Shepherdsville, KY
National Provider Identifier
1992384416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 255556
- Practice address
- 130 Joe B Hall Ave
Shepherdsville, KY 40165-6010 - Phone
- (502) 955-6447
- Fax
- (502) 955-7036
- NPI assigned
- Apr 2, 2021
- 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 | 255556 | KY | Primary |
Addresses
Primary practice location
130 Joe B Hall Ave
Shepherdsville, KY 40165-6010
Mailing address
10401 Linn Station Rd Ste 100
Louisville, KY 40223-3842
Phone (502) 589-8600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2023 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 255556 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1992384416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10401 LINN STATION RD STE 100",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402233842",
"telephone_number": "502-589-8600",
"fax_number": "502-589-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 JOE B HALL AVE",
"city": "SHEPHERDSVILLE",
"state": "KY",
"postal_code": "401656010",
"telephone_number": "502-955-6447",
"fax_number": "502-955-7036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CELES",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-02",
"last_updated": "2021-04-02",
"certification_date": "2021-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "255556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shepherdsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.