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General NPI Number Information
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NPI Number | 1891971024
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Entity Type | Organization
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Legal Business Name | AGNES SMITH AND ASSOCIATES
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 20600 CHAGRIN BLVD SUITE 440
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City | CLEVELAND
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State | OH
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Zip | 44122-5327
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Country | US
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Telephone | 216-921-4344
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Fax | 216-932-0818
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Provider Business Mailing Address
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Address Line | 20600 CHAGRIN BLVD SUITE 440
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City | CLEVELAND
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State | OH
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Zip | 44122-5327
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Country | US
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Telephone | 216-921-4344
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Fax | 216-932-0818
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Authorized Official
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Title or Position | OWNER
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Name | AGNES M. SMITH
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Credential | L.I.S.W.
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Telephone | 216-921-4344
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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 | I3608
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License Number State | OH
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