MEDICARE: CARLIN TAYLOR SMITH LMSW

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	1041C0700X	Clinical Social Worker	MSW011043	GA

General Provider Information

NPI Number	:	1285334607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLIN TAYLOR SMITH LMSW

Provider Business Mailing Address
First Line	:	3450 ROXBORO RD NE APT 1210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1806
Country	:	US
Telephone Number	:	540-905-1457
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 ROXBORO RD NE APT 1210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1806
Country	:	US
Telephone Number	:	540-905-1457
Fax Number	:

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

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/06/2023

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