Healthcare Provider Details

I. General information

NPI: 1427964386
Provider Name (Legal Business Name): MS. CHRISTINA DENISE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 CHANDLER ST
WORCESTER MA
01602-3339
US

IV. Provider business mailing address

196 COMMERCIAL ST APT 404
BRAINTREE MA
02184-3550
US

V. Phone/Fax

Practice location:
  • Phone: 508-799-0688
  • Fax:
Mailing address:
  • Phone: 617-997-8223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: