Healthcare Provider Details

I. General information

NPI: 1750295556
Provider Name (Legal Business Name): CHRISTINA SMITH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 STARLIGHT DR
COLLIERVILLE TN
38017-2905
US

IV. Provider business mailing address

522 STARLIGHT DR
COLLIERVILLE TN
38017-2905
US

V. Phone/Fax

Practice location:
  • Phone: 901-831-8899
  • Fax:
Mailing address:
  • Phone: 901-831-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16850
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: