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General NPI Number Information
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NPI Number | 1740685171
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Entity Type | Organization
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Legal Business Name | ALAN P. SMITH LCSW, PLLC
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 12/27/2021
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Provider Practice Location Address
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Address Line | 2588 ADDINGTON CIR
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City | ROCKLEDGE
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State | FL
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Zip | 32955-6509
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Country | US
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Telephone | 321-757-4030
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Fax | 321-369-9836
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Provider Business Mailing Address
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Address Line | 7777 N. WICKHAM RD SUITE 12 PMB 501
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City | MELBOURNE
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State | FL
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Zip | 32940-7530
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Country | US
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Telephone | 321-757-4030
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Fax | 321-369-9836
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Authorized Official
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Title or Position | OWNER
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Name | MR. ALAN P. SMITH
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Credential | LCSW
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Telephone | 321-757-4030
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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 | SW12016
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License Number State | FL
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