Healthcare Provider Details

I. General information

NPI: 1740102151
Provider Name (Legal Business Name): THOMAS SMYTHE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CHESTNUT HILL AVE
BRIGHTON MA
02135-4731
US

IV. Provider business mailing address

283 CHESTNUT AVE
JAMAICA PLAIN MA
02130-4415
US

V. Phone/Fax

Practice location:
  • Phone: 857-557-4535
  • Fax:
Mailing address:
  • Phone: 561-281-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number230812
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: