MEDICARE: KAMILAH AISHA SMILEY

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	21077	MD
2	1041C0700X	Clinical Social Worker	21077	MD

General Provider Information

NPI Number	:	1588136972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMILAH AISHA SMILEY

Provider Business Mailing Address
First Line	:	3117 PRESBURY ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-3415
Country	:	US
Telephone Number	:	443-401-5480
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 TAYLOR AVE STE 203
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-8333
Country	:	US
Telephone Number	:	443-279-5829
Fax Number	:

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

Provider Enumeration Date	:	12/22/2018
Last Update Date	:	12/22/2018

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Directions to “ KAMILAH AISHA SMILEY ” Practice Location

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