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General NPI Number Information
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NPI Number | 1619814282
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Entity Type | Individual
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Provider Name | SHANNON P SMITH LSW, LCADC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 281 STATE ROUTE 34 STE 202
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City | COLTS NECK
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State | NJ
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Zip | 07722-2439
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Country | US
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Telephone | 732-852-7879
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Fax |
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Provider Business Mailing Address
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Address Line | 1761 RALEIGH CT W APT 79B
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City | OCEAN
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State | NJ
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Zip | 07712-2639
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Country | US
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Telephone | 516-469-2988
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00418900
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License Number State | NJ
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