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NPI Code Detail

MEDICARE: DEVON SMITH

MEDICARE: DEVON SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW026301PA

General Provider Information

NPI Number : 1144919028
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVON SMITH
Provider Business Mailing Address
First Line : 1811 ROSELYN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-1331
Country : US
Telephone Number : 215-370-0589
Fax Number :
Provider Business Practice Location Address
First Line : 440 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-4090
Country : US
Telephone Number : 215-370-0589
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2023
Last Update Date : 08/31/2025

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Directions to “ DEVON SMITH ” Practice Location

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