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General NPI Number Information
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NPI Number | 1740350461
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Entity Type | Individual
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Provider Name | NANCY M SMITH MSW, LCSW, LAC
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 304 4TH AVE E
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City | SUPERIOR
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State | MT
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Zip | 59872-3075
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Country | US
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Telephone | 406-822-5422
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Fax | 406-324-7062
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Provider Business Mailing Address
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Address Line | 89 MILL CREEK RD
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City | SAINT REGIS
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State | MT
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Zip | 59866-9710
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Country | US
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Telephone | 406-649-2761
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Fax | 406-822-5423
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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 | 635
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 765
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License Number State | MT
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