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General NPI Number Information
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NPI Number | 1952052268
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Entity Type | Individual
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Provider Name | KELLY E SMOAK LCSWA
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Gender | Female
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 139 E TRADE ST
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City | FOREST CITY
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State | NC
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Zip | 28043-3149
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Country | US
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Telephone | 828-245-7871
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Fax |
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Provider Business Mailing Address
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Address Line | 203 SHERWOOD DR
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City | GAFFNEY
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State | SC
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Zip | 29340-2941
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Country | US
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Telephone | 864-838-7056
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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 | P017210
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License Number State | NC
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