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General NPI Number Information
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NPI Number | 1285258277
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Entity Type | Individual
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Provider Name | QUINDA C SMITH MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 2993 BROADMOOR VALLEY RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4471
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Country | US
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Telephone | 719-640-1839
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Fax |
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Provider Business Mailing Address
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Address Line | 2993 BROADMOOR VALLEY RD STE 103
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4471
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Country | US
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Telephone | 719-301-7731
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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 | CSW.09927114
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License Number State | CO
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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 | LSW.0009922474
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License Number State | CO
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