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NPI Code Detail

MEDICARE: CHRYSTAL JEAN SMITH L,C.S.W.

MEDICARE:   CHRYSTAL JEAN SMITH  L,C.S.W.
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 WorkerCSW003123GA
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1932263217
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRYSTAL JEAN SMITH L,C.S.W.
Provider Business Mailing Address
First Line : 1410 DOUBLE CHURCHES RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-2605
Country : US
Telephone Number : 706-681-3278
Fax Number : 706-321-9757
Provider Business Practice Location Address
First Line : 1410 DOUBLE CHURCHES RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-2605
Country : US
Telephone Number : 706-681-3278
Fax Number : 706-321-9757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 09/11/2025

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Directions to “ CHRYSTAL JEAN SMITH L,C.S.W.” Practice Location

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