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General NPI Number Information
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NPI Number | 1609238476
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Entity Type | Individual
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Provider Name | ROSALYN DENISE SMITH LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 7825 BROAD RIVER ROAD SUITE 200
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City | IRMO
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State | SC
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Zip | 29063
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Country | US
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Telephone | 803-262-0794
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Fax |
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Provider Business Mailing Address
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Address Line | 7825 BROAD RIVER ROAD SUITE 200
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City | IRMO
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State | SC
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Zip | 29063
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Country | US
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Telephone | 803-262-0794
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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 | 6801098218
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW008911
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 111674
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15482
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C016286
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License Number State | NC
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