MEDICARE: MRS. ALYSSA JEAN 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	9205	TN

General Provider Information

NPI Number	:	1982164687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALYSSA JEAN SMITH LCSW

Provider Business Mailing Address
First Line	:	205 HORACE MANN DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37218-1225
Country	:	US
Telephone Number	:	973-626-0308
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 GLEN ECHO RD STE 204
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2898
Country	:	US
Telephone Number	:	973-626-0308
Fax Number	:

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

Provider Enumeration Date	:	03/20/2019
Last Update Date	:	12/04/2024

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