MEDICARE: MR. HENRY LEE SMITH JR. 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
1	1041C0700X	Clinical Social Worker	CSW.09932722	CO
2	1041C0700X	Clinical Social Worker	SWB-2026-0029	NM
3	1041C0700X	Clinical Social Worker	LICSW1143442	MA
4	1041C0700X	Clinical Social Worker	SW25167	FL
5	1041C0700X	Clinical Social Worker	149031836	IL

General Provider Information

NPI Number	:	1336686450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HENRY LEE SMITH JR. LCSW

Provider Business Mailing Address
First Line	:	1515 N FLAGLER DR STE 101
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-3429
Country	:	US
Telephone Number	:	561-833-9469
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 N FLAGLER DR STE 101
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-3429
Country	:	US
Telephone Number	:	561-833-9469
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2017
Last Update Date	:	05/18/2026

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