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General NPI Number Information
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NPI Number | 1467986612
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Entity Type | Individual
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Provider Name | AISHA DENICE SMITH LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/14/2017
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 40 RECTOR ST 14TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10006-1705
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Country | US
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Telephone | 212-832-7605
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 BROADWAY APT E28E
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City | NEW YORK
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State | NY
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Zip | 10031-8719
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Country | US
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Telephone | 347-322-6392
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 100117
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License Number State | NY
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