Healthcare Provider Details

I. General information

NPI: 1447122452
Provider Name (Legal Business Name): DAELYN SMITH LMSW-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 STONECIPHER DR
ADA OK
74820-3439
US

IV. Provider business mailing address

124 E MAIL SUITE B4 SUITE B4
ADA OK
74820-5623
US

V. Phone/Fax

Practice location:
  • Phone: 580-436-7206
  • Fax: 580-272-5757
Mailing address:
  • Phone: 580-436-7206
  • Fax: 580-272-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21686-P
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: