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General NPI Number Information
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NPI Number | 1205422029
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Entity Type | Individual
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Provider Name | KRISTEN N SMITH LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 611 WEST MAIN STREET
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City | WATERTOWN
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State | NY
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Zip | 13601-2416
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Country | US
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Telephone | 315-755-2033
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Fax |
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Provider Business Mailing Address
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Address Line | 5407 BRIDEGEWOOD DRIVE
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City | KILLEEN
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State | TX
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Zip | 76549-5628
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Country | US
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Telephone | 315-778-7908
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Fax | 315-785-8628
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 110497
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | NY
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