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General NPI Number Information
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NPI Number | 1780782250
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Entity Type | Individual
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Provider Name | CAROL M SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 770 E MAIN ST
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3073
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Country | US
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Telephone | 856-234-7422
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Fax | 609-386-8674
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Provider Business Mailing Address
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Address Line | 117 E MAPLE AVE
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City | MOORESTOWN
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State | NJ
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Zip | 08057-2009
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Country | US
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Telephone | 856-235-6308
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Fax | 609-386-8674
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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 | 44SC00037500
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License Number State | NJ
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