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NPI Code Detail

MEDICARE: NICOLE SMITH LCSW

MEDICARE: NICOLE SMITH LCSW
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 Worker9479TN
2104100000XSocial Worker12226TN

General Provider Information

NPI Number : 1265190672
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE SMITH LCSW
Provider Business Mailing Address
First Line : 3200 W END AVE STE 500
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1322
Country : US
Telephone Number : 205-643-0110
Fax Number :
Provider Business Practice Location Address
First Line : 3200 W END AVE STE 500
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1322
Country : US
Telephone Number : 615-319-8063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2021
Last Update Date : 04/08/2025

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