KYNESHA SMITH LISW-CP
NPI 1609586155
Social Worker in St Petersburg, FL

Q: What is Kynesha Smith's NPI number?

The NPI number for Kynesha Smith is 1609586155. It was assigned to this individual provider in the NPPES registry on November 24, 2022.

Q: What is Kynesha Smith's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Kynesha Smith was last updated on September 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since November 24, 2022PECOS Enrolled

7901 4TH ST N STE 4000, ST PETERSBURG, FL 33702(404) 981-5004 Get Directions Write a Review

NPPES record last updated: September 6, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 6, 2023, Jan 6, 2023, Nov 24, 2022 (3 updates tracked since 2022).

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About Kynesha Smith Lisw-cp NPPES

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

KYNESHA SMITH LISW-CP (NPI 1609586155) is an individual social worker in St Petersburg, Florida, licensed in South Carolina (15703) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Columbia, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1609586155

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameKYNESHA SMITHCredential: LISW-CP

Location Address7901 4TH ST N STE 4000St Petersburg, FL 33702-4305

Mailing AddressPo Box 248Mayesville, SC 29104-0248 · (404) 981-5004

Phone(404) 981-5004

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateNovember 24, 2022

Last NPPES UpdateSeptember 6, 20233 updates tracked since enumeration

NPPES CertifiedSeptember 6, 2023

✔ NPI 1609586155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Licenses✔ Licensed in SC · 15703✔ Licensed in SC · 13386

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

7901 4TH ST N STE 4000, St Petersburg, FL 33702

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Secondary Practice Location 1

Location 1136 Forum Dr Ste 4Columbia, SC 29229-7980 · Phone (706) 928-6260

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.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)

Kynesha Smith Lisw-cp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183078900

PECOS Enrollment IDI20251031001732

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.

Other Providers at the Same Location NPPES 11

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

THE LUMINESCENT MIND, LLC

Counselor (Mental Health)