MEDICARE: JALIA DENISE HURST-SMART MSW, 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	SW20038	FL

General Provider Information

NPI Number	:	1518471655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JALIA DENISE HURST-SMART MSW, LCSW

Provider Business Mailing Address
First Line	:	12486 BERKELEY SQUARE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2543
Country	:	US
Telephone Number	:	813-641-4777
Fax Number	:

Provider Business Practice Location Address
First Line	:	12486 BERKELEY SQUARE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-2543
Country	:	US
Telephone Number	:	813-641-4777
Fax Number	:

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

Provider Enumeration Date	:	11/28/2017
Last Update Date	:	06/16/2026

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