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

Mr. Kenneth David Smith, LCSW

Individual provider Clinical Social Worker · NPI 1447704770

Mr. Kenneth David Smith, LCSW is a Clinical Social Worker in Grants Pass, Oregon. Qualified in 2018, 8 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California, Idaho and Oregon.

Years since qualifying
8
Licensed in
CA, ID, OR
In the registry since
2016
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

524 NW Woodson Dr
Grants Pass, OR 97526-1174
Phone: (541) 264-5687
Fax: (541) 205-9431
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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 L11298 (OR)
Clinical Social Worker Taxonomy 1041C0700X · Licence 43576 (ID)
Clinical Social Worker Taxonomy 1041C0700X · Licence 124154 (CA)

Record details

NPI number1447704770
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedAugust 3, 2016
Last updated in NPPESAugust 29, 2024
Certification dateAugust 29, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Grants Pass