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

Mr. Larry William Smith, LCSW106859

Individual provider Clinical Social Worker · NPI 1306366182

Mr. Larry William Smith, LCSW106859 is a Clinical Social Worker in Cleveland, Tennessee. Qualified in 2015, 11 years ago. Practices with Sud Specialty Group - Ca, a 499-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California, Connecticut, Nevada and Virginia.

Years since qualifying
11
Licensed in
CA, CT, NV, VA
In the registry since
2017
Specialties on file
4
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Practice location Address checks out

5046 Skyline Way NE
Cleveland, TN 37312-2492
Phone: (909) 440-0082
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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 106859 (CA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 0904019034 (VA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 12697-C (NV)
Clinical Social Worker Taxonomy 1041C0700X · Licence 016507 (CT)

Record details

NPI number1306366182
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW106859
Sole proprietorYes
NPI enumeratedJune 22, 2017
Last updated in NPPESMay 15, 2026
Certification dateMay 15, 2026
Mailing address5046 Skyline Way Ne, Cleveland, TN 37312-2492

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Sud Specialty Group - Ca — 499 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Cleveland