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NPI Code Detail

MEDICARE: MARJORIE A SMITH LCSW

MEDICARE: MARJORIE A 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
1104100000XSocial Worker069666NY

General Provider Information

NPI Number : 1659405199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE A SMITH LCSW
Provider Business Mailing Address
First Line : 28 SLEEPY HOLW
Second Line :
City : ROCHESTER
State : NY
Zip : 14624-4472
Country : US
Telephone Number : 585-451-2805
Fax Number :
Provider Business Practice Location Address
First Line : 2300 EAST AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14610-2564
Country : US
Telephone Number : 585-484-0118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 01/04/2024

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