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General NPI Number Information
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NPI Number | 1336772656
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Entity Type | Individual
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Provider Name | LAUREN RACHELLE SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/14/2020
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 275 4TH ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-3205
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Country | US
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Telephone | 727-304-5732
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Fax |
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Provider Business Mailing Address
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Address Line | 10105 BERRYESSA AVE
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City | RIVERVIEW
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State | FL
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Zip | 33578-9312
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Country | US
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Telephone | 901-212-3435
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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 |
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License Number State |
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