Healthcare Provider Details

I. General information

NPI: 1083819940
Provider Name (Legal Business Name): DEBORAH F SMITH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1084 JOHNS WAY
LAWRENCEBURG KY
40342-8808
US

IV. Provider business mailing address

1084 JOHNS WAY
LAWRENCEBURG KY
40342-8808
US

V. Phone/Fax

Practice location:
  • Phone: 727-403-3817
  • Fax:
Mailing address:
  • Phone: 727-403-3817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW8172
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: