Doctor Name: | GREGORY SMITH |
NPI Number: | 1073907267 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW-CPS |
License Number: | 5078 |
Business Practice Address: | 161 Landmark Dr Taylors, SC - 296872819 |
Business Phone Number: | 8642440154 |
Business Fax Number: | 8646095003 |
Mailing Address: | 161 Landmark Dr, TAYLORS |
State: | SC |
Postal Code: | 296872819 |
Phone Number: | 8642440154 |
Fax Number: | 8646095003 |
NPI Enumeration Date: | 03/25/2015 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 5078 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |