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NPI Code Detail

MEDICARE: MRS. ALICIA DARLENE SMITH LCSW

MEDICARE: MRS. ALICIA DARLENE 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
11041C0700XClinical Social WorkerLICSW1140658MA
21041C0700XClinical Social WorkerCSW004749GA

General Provider Information

NPI Number : 1639421407
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALICIA DARLENE SMITH LCSW
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 678-213-2194
Fax Number :
Provider Business Practice Location Address
First Line : 4255 WADE GREEN RD NW STE 414
Second Line :
City : KENNESAW
State : GA
Zip : 30144-1763
Country : US
Telephone Number : 678-213-2194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2012
Last Update Date : 03/24/2026

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