Healthcare Provider Details

I. General information

NPI: 1578474763
Provider Name (Legal Business Name): KAMBRIE ELAINE SMITH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DONALDS WAY STE 201
E BRIDGEWATER MA
02333-1480
US

IV. Provider business mailing address

1 DONALDS WAY STE 201
E BRIDGEWATER MA
02333-1480
US

V. Phone/Fax

Practice location:
  • Phone: 508-894-0424
  • Fax:
Mailing address:
  • Phone: 508-894-0424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2144011
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: