MRS. JESSIE ROSANNE SMITH (LCSW) – Clinical Social Worker, NPI 1063766830

MRS. JESSIE ROSANNE SMITH (LCSW) is a healthcare provider. based in Olney, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149.013667 (IL). The NPI Number for MRS. JESSIE ROSANNE SMITH (LCSW) is 1063766830

Main info

Female
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JESSIE ROSANNE SMITH (LCSW)
NPI
1063766830
Phone
(618) 839-4871
Address
3778 N MERIDIAN RD
Enumeration Date
1 November 2012
Last Update Date
1 November 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6186622191
Graduation Year
2003 (23 years ago)
PAC ID
1951785666
Group Practice PAC ID
0042101982
Professional Enrollment ID
I20220830002079
Address ID
IL628241113CL939XXSWXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for MRS. JESSIE ROSANNE SMITH (LCSW)

  • 3778 N MERIDIAN RD

    OLNEY, IL 624504815

    Phone: (618) 839-4871

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-08-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220830002079IClinical Social WorkerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62450)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042101982View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Clinical Social WorkerIL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)MO
Family PracticeIL
General SurgeryIL
Nurse PractitionerIL
Diagnostic RadiologyFL

Reviews

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Frequently asked questions

What NPI should I save for MRS. JESSIE ROSANNE SMITH (LCSW)?
Save NPI 1063766830 if you need a stable reference for MRS. JESSIE ROSANNE SMITH (LCSW).
Does this profile mean MRS. JESSIE ROSANNE SMITH (LCSW) is currently active?
Yes — MRS. JESSIE ROSANNE SMITH (LCSW) appears active in the national provider directory.
What field does MRS. JESSIE ROSANNE SMITH (LCSW) work in?
You can think of MRS. JESSIE ROSANNE SMITH (LCSW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location metadata exists for MRS. JESSIE ROSANNE SMITH (LCSW)?
The page summarizes Olney, Illinois for MRS. JESSIE ROSANNE SMITH (LCSW); expand the address list for detail.
How can I contact MRS. JESSIE ROSANNE SMITH (LCSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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