MEDICARE: BARBARA A 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
1	1041C0700X	Clinical Social Worker	SW6906	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376743005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA A SMITH LCSW

Provider Business Mailing Address
First Line	:	11165 JENNY WREN RD
Second Line	:
City	:	WEEKI WACHEE
State	:	FL
Zip	:	34614-3128
Country	:	US
Telephone Number	:	855-241-7160
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 NE 18TH AVE
Second Line	:	#1207
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3063
Country	:	US
Telephone Number	:	855-241-7160
Fax Number	:

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

Provider Enumeration Date	:	07/20/2007
Last Update Date	:	10/09/2012

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