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NPI Code Detail

MEDICARE: JANELLE M SMITH LCSW-R

MEDICARE: JANELLE M SMITH LCSW-R
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
11041C0700XClinical Social Worker067946-1NY
21041C0700XClinical Social WorkerR075608NY

General Provider Information

NPI Number : 1588791388
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE M SMITH LCSW-R
Provider Business Mailing Address
First Line : 346 GRAND AVE
Second Line :
City : JOHNSON CITY
State : NY
Zip : 13790-2558
Country : US
Telephone Number : 607-432-8477
Fax Number : 607-432-3150
Provider Business Practice Location Address
First Line : 179 RIVER ST
Second Line :
City : ONEONTA
State : NY
Zip : 13820-2239
Country : US
Telephone Number : 607-432-8477
Fax Number : 607-432-3150
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 04/24/2014

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Directions to “ JANELLE M SMITH LCSW-R” Practice Location

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