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NPI Code Detail

MEDICARE: MS. NICOLE SMITH LSW

MEDICARE: MS. NICOLE SMITH LSW
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
11041C0700XClinical Social WorkerS.2310233OH

General Provider Information

NPI Number : 1083484950
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE SMITH LSW
Provider Business Mailing Address
First Line : 17371 DRIVER COLLINS RD
Second Line :
City : MOUNT ORAB
State : OH
Zip : 45154-8125
Country : US
Telephone Number : 937-515-2981
Fax Number :
Provider Business Practice Location Address
First Line : 7243 EASTLAWN DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3515
Country : US
Telephone Number : 513-706-2257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2024
Last Update Date : 03/06/2025

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Directions to “ MS. NICOLE SMITH LSW” Practice Location

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