Healthcare Provider Details

I. General information

NPI: 1053587311
Provider Name (Legal Business Name): ANNEMARIE SMITH LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3995 E MARKET ST
YORK PA
17402-2773
US

IV. Provider business mailing address

7111 S SENTINEL LN
YORK PA
17403-9486
US

V. Phone/Fax

Practice location:
  • Phone: 717-757-1227
  • Fax:
Mailing address:
  • Phone: 717-424-8315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW015957
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: