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General NPI Number Information
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NPI Number | 1831440627
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Entity Type | Individual
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Provider Name | LAURA J SMITH LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 77 MALDEN ST APT 2
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City | EVERETT
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State | MA
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Zip | 02149-5355
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Country | US
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Telephone | 781-215-4745
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Fax |
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Provider Business Mailing Address
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Address Line | 8 ESSEX CENTER DR STE 300
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City | PEABODY
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State | MA
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Zip | 01960-2964
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Country | US
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Telephone | 978-605-4428
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Fax | 978-849-6306
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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 | 122071
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License Number State | MA
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