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General NPI Number Information
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NPI Number | 1639421407
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Entity Type | Individual
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Provider Name | ALICIA DARLENE SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 1 EMERSON PL STE 3H
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City | BOSTON
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State | MA
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Zip | 02114-2252
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Country | US
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Telephone | 339-666-8516
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | 1125 LAUREN WAY NW
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City | ACWORTH
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State | GA
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Zip | 30101-3887
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Country | US
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Telephone | 423-255-2357
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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 | LICSW1140658
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License Number State | MA
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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 | CSW004749
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License Number State | GA
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