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General NPI Number Information
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NPI Number | 1588384598
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Entity Type | Individual
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Provider Name | CHELSEA CHANTREZ SMITH BSW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 2133 E BERT KOUNS INDUSTRIAL LOOP
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City | SHREVEPORT
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State | LA
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Zip | 71105-5314
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Country | US
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Telephone | 318-221-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 1618 MAIN ST
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City | HAYNESVILLE
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State | LA
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Zip | 71038-5004
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Country | US
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Telephone | 318-624-4935
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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 |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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