MEDICARE: KELLY LACHELLE SMITH LCSW

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
2	1041C0700X	Clinical Social Worker	PO11783	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831490903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY LACHELLE SMITH LCSW

Provider Business Mailing Address
First Line	:	7410 NICCOLINE LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-8079
Country	:	US
Telephone Number	:	562-743-8166
Fax Number	:

Provider Business Practice Location Address
First Line	:	3117 WHITING AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-1648
Country	:	US
Telephone Number	:	980-243-5595
Fax Number	:

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

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	02/26/2024

Similar Medicare Providers

1659236404 — A NEW HOPE HOME CARE LLC
Practice Location Address:

3117 WHITING AVE STE 208
CHARLOTTE, NC
28205-1648

Practice Phone: 903-466-1600
Practice Fax:

1356320790 — MR. GEORGE EDWARD TILLEY LCSW
Practice Location Address:

3117 WHITING AVE
CHARLOTTE, NC
28205-1648

Practice Phone: 910-508-7400
Practice Fax:

1255854550 — COURTNEY COSTA LCSW
Practice Location Address:

3117 WHITING AVE
CHARLOTTE, NC
28205-1648

Practice Phone: 919-866-2273
Practice Fax:

1306455126 — A PLACE 4 ME, LLC
Practice Location Address:

3117 WHITING AVE STE 125
CHARLOTTE, NC
28205-1648

Practice Phone: 980-243-5595
Practice Fax: 980-245-5595

1588279251 — STRIDE SERVICES LLC
Practice Location Address:

3117 WHITING AVE
CHARLOTTE, NC
28205-1648

Practice Phone: 980-422-4468
Practice Fax:

1134889140 — FORTUNE HEART OF NORTH CAROLINA HOME CARE LLC
Practice Location Address:

3117 WHITING AVE
CHARLOTTE, NC
28205-1648

Practice Phone: 980-306-4777
Practice Fax:

Directions to “ KELLY LACHELLE SMITH LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.