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NPI Code Detail

MEDICARE: MS. MAGGIE MARIE SMITH

MEDICARE: MS. MAGGIE MARIE 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
11041C0700XClinical Social Worker11694CT
21041C0700XClinical Social WorkerLICSW1140324MA

General Provider Information

NPI Number : 1982266995
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAGGIE MARIE SMITH
Provider Business Mailing Address
First Line : 1 CELLINI PL
Second Line :
City : WEST HAVEN
State : CT
Zip : 06516-1666
Country : US
Telephone Number : 203-932-6481
Fax Number :
Provider Business Practice Location Address
First Line : 280 BEACH ST
Second Line :
City : REVERE
State : MA
Zip : 02151-3143
Country : US
Telephone Number : 781-289-5057
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2019
Last Update Date : 12/03/2025

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Directions to “ MS. MAGGIE MARIE SMITH ” Practice Location

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