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NPI Code Detail

MEDICARE: CARLA M SMITH CSW

MEDICARE: CARLA M SMITH CSW
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 Worker6801078178MI

General Provider Information

NPI Number : 1841230745
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA M SMITH CSW
Provider Business Mailing Address
First Line : 5262 LANNOO ST
Second Line :
City : GROSSE POINTE
State : MI
Zip : 48236-2138
Country : US
Telephone Number : 313-695-8344
Fax Number :
Provider Business Practice Location Address
First Line : 4777 E OUTER DR
Second Line : STE 183
City : DETROIT
State : MI
Zip : 48234-3241
Country : US
Telephone Number : 586-738-4374
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 06/17/2020

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Directions to “ CARLA M SMITH CSW” Practice Location

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