MEDICARE: RANDA SMITH MSW, LSW

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
1	104100000X	Social Worker	SW143658	PA

General Provider Information

NPI Number	:	1235999046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDA SMITH MSW, LSW

Provider Business Mailing Address
First Line	:	205 GRANDVIEW AVE STE 404
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-425-0326
Fax Number	:	717-695-6357

Provider Business Practice Location Address
First Line	:	205 GRANDVIEW AVE STE 404
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-425-0326
Fax Number	:	717-695-6357

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	01/08/2026

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