MEDICARE: REGINA 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
1	104100000X	Social Worker	S0024978	OH

General Provider Information

NPI Number	:	1437615473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA SMITH LSW

Provider Business Mailing Address
First Line	:	1255 EAST 101ST STEET
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108
Country	:	US
Telephone Number	:	216-795-1723
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 EAST 101ST STEET
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44108
Country	:	US
Telephone Number	:	216-795-1723
Fax Number	:

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

Provider Enumeration Date	:	02/14/2019
Last Update Date	:	05/08/2025

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