MEDICARE: RASHEIM 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	096212	NY

General Provider Information

NPI Number	:	1912479122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHEIM SMITH LCSW

Provider Business Mailing Address
First Line	:	105 W 125TH ST FRNT 1
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4444
Country	:	US
Telephone Number	:	201-702-1307
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 WEST 125TH ST FRONT 1
Second Line	:	1316
City	:	NEW YORK
State	:	NY
Zip	:	10027-4444
Country	:	US
Telephone Number	:	917-459-6037
Fax Number	:

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

Provider Enumeration Date	:	12/28/2018
Last Update Date	:	01/28/2026

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