Marissa Nicole Smith
Social Worker, Clinical in Chicago, IL. Individual provider (NPI-1).
NPI number1609797802
StatusActive
Last updated in NPPESJul 23, 2026
Details
- NPI
- 1609797802
- Entity type
- Individual (NPI-1)
- Name
- Marissa Nicole Smith
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 23, 2026
- Certification date
- Jul 23, 2026
- Last updated
- Jul 23, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
4501 S Calumet Ave Apt 2nChicago, IL 60653-5217
Phone 309-613-2375
Mailing address
4501 S Calumet Ave Apt 2nChicago, IL 60653-5217
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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