Doctor Name: | MRS. NICOLE E SMITH |
NPI Number: | 1063604304 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | C004381 |
Business Practice Address: | 105 N Church St Ste B Clayton, NC - 275202486 |
Business Phone Number: | 9194645421 |
Business Fax Number: | |
Mailing Address: | Po Box 58, CLAYTON |
State: | NC |
Postal Code: | 275280058 |
Phone Number: | 9194645421 |
Fax Number: | |
NPI Enumeration Date: | 08/10/2007 |
NPI Last Update Date: | 01/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | C004381 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |