Healthcare Provider Details

I. General information

NPI: 1457807265
Provider Name (Legal Business Name): CHARITY SMITH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 SEWARD DR
HAMPTON VA
23663-1124
US

IV. Provider business mailing address

115 OVERSTREET CT
WILLIAMSBURG VA
23185-5237
US

V. Phone/Fax

Practice location:
  • Phone: 757-232-9505
  • Fax:
Mailing address:
  • Phone: 757-232-9505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number34011923A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904009224
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9719
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: