Healthcare Provider Details

I. General information

NPI: 1336686450
Provider Name (Legal Business Name): HENRY LEE SMITH JR. LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N FLAGLER DR STE 101
WEST PALM BEACH FL
33401-3429
US

IV. Provider business mailing address

1515 N FLAGLER DR STE 101
WEST PALM BEACH FL
33401-3429
US

V. Phone/Fax

Practice location:
  • Phone: 561-833-9469
  • Fax:
Mailing address:
  • Phone: 561-833-9469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09932722
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-0029
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1143442
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW25167
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149031836
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: