MEDICARE: MRS. MELANIE JENNIFER SMITH

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	16-1647383	LA

General Provider Information

NPI Number	:	1801754668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELANIE JENNIFER SMITH

Provider Business Mailing Address
First Line	:	1000 CHINABERRY DR STE 900
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-2455
Country	:	US
Telephone Number	:	318-675-0804
Fax Number	:

Provider Business Practice Location Address
First Line	:	3341 YOUREE DR STE 10
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2149
Country	:	US
Telephone Number	:	318-675-0804
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/19/2026

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