Healthcare Provider Details

I. General information

NPI: 1376427591
Provider Name (Legal Business Name): CAROLINE SMITH LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 RAYNOLDS PL SE
WASHINGTON DC
20020-3246
US

IV. Provider business mailing address

925 N GARFIELD ST APT 206
ARLINGTON VA
22201-2183
US

V. Phone/Fax

Practice location:
  • Phone: 202-750-7177
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberLG200003292
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: