Doctor Name: | ALPHONSO SMITH |
NPI Number: | 1396713004 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | CW013500 |
Business Practice Address: | 630 Fairview Rd Suite 209 Swarthmore, PA - 190812334 |
Business Phone Number: | 6105443660 |
Business Fax Number: | 6105443662 |
Mailing Address: | 220 Commerce Dr, Suite 401 FORT WASHINGTON |
State: | PA |
Postal Code: | 190342402 |
Phone Number: | 2155405860 |
Fax Number: | 2155405860 |
NPI Enumeration Date: | 03/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CW013500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |