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MARK WILLIAM SMITH LICSW
NPI 1508988908
Social Worker - Clinical in Minneapolis, MN

Active since April 04, 2007PECOS Enrolled
5939 PORTLAND AVE, MINNEAPOLIS, MN 55417(612) 866-6100(612) 866-9379 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark William Smith Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK WILLIAM SMITH LICSW (NPI 1508988908) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (11372) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1508988908
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMARK WILLIAM SMITHCredential: LICSW
Location Address5939 PORTLAND AVEMinneapolis, MN 55417-3127
Mailing Address5939 Portland AveMinneapolis, MN 55417-3127 · (612) 866-6100 · Fax (612) 866-9379
Phone(612) 866-6100
Fax(612) 866-9379
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateApril 4, 2007
Last NPPES UpdateJuly 9, 2007
✔ NPI 1508988908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 11372
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
5939 PORTLAND AVE, Minneapolis, MN 55417
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Other Identifiers 1

Other102R8SMMN · Blue Cross Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark William Smith Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5294791109
PECOS Enrollment IDI20041203000080
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55417 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ELIZABETH ANN ROYSTER LMFT
Marriage & Family Therapist
5939 PORTLAND AVE
MINNEAPOLIS, MN 55417
Hennepin County (612) 866-6100
CROSSTOWN COUNSELING, PLC
Counselor (Mental Health)
5939 PORTLAND AVE
MINNEAPOLIS, MN 55417
Hennepin County (612) 866-6100
LISA XIONG
Physician Assistant
5939 PORTLAND AVE
MINNEAPOLIS, MN 55417
Hennepin County (612) 869-4444
DIAMOND LAKE CLINIC, P.C.
Clinic/Center (Health Service)
5939 PORTLAND AVE
MINNEAPOLIS, MN 55417
Hennepin County (612) 806-3011
NOUSSAIBA AYOUR PA-C
Physician Assistant (Medical)
5939 PORTLAND AVE
MINNEAPOLIS, MN 55417
Hennepin County (612) 869-4444
JESSICA MAGARITE PUSCH LPCC, LADC
Counselor (Professional)
5939 PORTLAND AVE
MINNEAPOLIS, MN 55417
Hennepin County (612) 869-4444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Smith's NPI number?

The NPI number for Mark Smith is 1508988908. It was assigned to this individual provider in the NPPES registry on April 4, 2007.

Where is Mark Smith located?

Mark Smith practices at 5939 Portland Ave, Minneapolis, MN 55417. The listed phone number is (612) 866-6100.

What is Mark Smith's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Mark Smith enrolled in Medicare?

Yes. Mark Smith is registered in the Medicare PECOS enrollment system.

What insurance does Mark Smith accept?

Health plans from HealthPartners list Mark Smith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Smith was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.