| Doctor Name: | MR. CARROLL PAUL SMITH |
| NPI Number: | 1013206606 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | C0876 |
| Business Practice Address: | 720 Avignon Dr Suite 3 Ridgeland, MS - 391575166 |
| Business Phone Number: | 6012596714 |
| Business Fax Number: | 6016052710 |
| Mailing Address: | 225 Dublin Ct, BRANDON |
| State: | MS |
| Postal Code: | 390478035 |
| Phone Number: | 6012596714 |
| Fax Number: | 6016052710 |
| NPI Enumeration Date: | 04/04/2011 |
| NPI Last Update Date: | 04/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C0876 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |