Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark William Smith, LICSW

Individual provider Clinical Social Worker · NPI 1508988908

Mark William Smith, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Qualified in 1995, 31 years ago. Licensed in Minnesota.

Years since qualifying
31
Licensed in
MN
In the registry since
2007
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

5939 Portland Ave
Minneapolis, MN 55417-3127
Phone: (612) 866-6100
Fax: (612) 866-9379
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 11372 (MN)

Record details

NPI number1508988908
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 4, 2007
Last updated in NPPESJuly 9, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Not indicated

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