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NPI Code Detail

MEDICARE: MISS LATIVIA SMITH LMSW-C

MEDICARE: MISS LATIVIA SMITH LMSW-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor6801109132MI
3104100000XSocial Worker
4104100000XSocial Worker6801109132MI
51041C0700XClinical Social Worker

General Provider Information

NPI Number : 1033453139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LATIVIA SMITH LMSW-C
Provider Business Mailing Address
First Line : 34290 FORD RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-3051
Country : US
Telephone Number : 313-717-1830
Fax Number :
Provider Business Practice Location Address
First Line : 34290 FORD RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-3051
Country : US
Telephone Number : 313-717-1830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 01/11/2024

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Directions to “ MISS LATIVIA SMITH LMSW-C” Practice Location

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