Healthcare Provider Details

I. General information

NPI: 1174299705
Provider Name (Legal Business Name): ABIGAIL NOELLE SMITH MSW, LMSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E CESAR E CHAVEZ AVE
LANSING MI
48906-4348
US

IV. Provider business mailing address

1418 E MOUNT HOPE AVE
LANSING MI
48910-1831
US

V. Phone/Fax

Practice location:
  • Phone: 919-438-1674
  • Fax:
Mailing address:
  • Phone: 330-931-5927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801121563
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2507413
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: