MEDICARE: TORQUESIA 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
1	1041C0700X	Clinical Social Worker	CSW007012	GA

General Provider Information

NPI Number	:	1750999710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORQUESIA SMITH LCSW

Provider Business Mailing Address
First Line	:	2532 N DECATUR RD APT 1304
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-6177
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3904 N DRUID HILLS RD STE 243
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-3105
Country	:	US
Telephone Number	:	404-590-4404
Fax Number	:

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

Provider Enumeration Date	:	07/16/2020
Last Update Date	:	07/16/2020

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Directions to “ TORQUESIA SMITH LCSW” Practice Location

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