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General NPI Number Information
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NPI Number | 1093821043
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Entity Type | Individual
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Provider Name | ALAN P SMITH LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 2588 ADDINGTON CIR
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City | ROCKLEDGE
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State | FL
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Zip | 32955-6509
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Country | US
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Telephone | 321-757-4030
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Fax | 321-369-9836
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Provider Business Mailing Address
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Address Line | 7777 N. WICKHAM ROAD SUITE 12 PMB 501
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City | MELBOURNE
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State | FL
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Zip | 32940-7522
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Country | US
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Telephone | 321-757-4030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C008703
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R040648-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW12016
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License Number State | FL
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