=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063193142
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TORI SMITH LEWIS LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2023
-----------------------------------------------------
Last Update Date | 08/10/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1118 E MAIN STREET SALISBURY, MD 21804
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-690-4805
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 480 MAIN ST APT 210
-----------------------------------------------------
City | STEVENSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21666-4083
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-565-9306
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 29026
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------