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General NPI Number Information
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NPI Number | 1821732033
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Entity Type | Individual
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Provider Name | NICOLE ANN SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/24/2022
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Last Update Date | 04/24/2022
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Provider Practice Location Address
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Address Line | 7905 E 21ST AVE
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City | DENVER
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State | CO
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Zip | 80238-4119
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Country | US
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Telephone | 908-507-8753
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Fax |
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Provider Business Mailing Address
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Address Line | 1921 BAYONNE ST
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City | SARASOTA
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State | FL
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Zip | 34231-7737
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Country | US
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Telephone | 908-507-8753
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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 | SW18003
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License Number State | FL
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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 | CSW.09926936
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License Number State | CO
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