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General NPI Number Information
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NPI Number | 1316133887
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Entity Type | Individual
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Provider Name | SHIRENA SIMPSON-SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 612 PASTEUR DR SUITE 400
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City | GREENSBORO
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State | NC
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Zip | 27403-1149
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Country | US
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Telephone | 336-451-1113
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Fax | 336-292-6711
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Provider Business Mailing Address
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Address Line | 3405 W WENDOVER AVE STE A
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City | GREENSBORO
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State | NC
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Zip | 27407-1525
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Country | US
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Telephone | 336-294-1349
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Fax | 336-292-6711
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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 | C005803
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License Number State | NC
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