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NPI Code Detail

MEDICARE: DEANNA SMITH LCSW

MEDICARE:   DEANNA  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
1104100000XSocial WorkerCSW001755GA

General Provider Information

NPI Number : 1992838841
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANNA SMITH LCSW
Provider Business Mailing Address
First Line : 561 THORNTON RD STE R
Second Line :
City : LITHIA SPRINGS
State : GA
Zip : 30122-1558
Country : US
Telephone Number : 770-941-4529
Fax Number : 770-941-5675
Provider Business Practice Location Address
First Line : 561 THORNTON RD STE R
Second Line :
City : LITHIA SPRINGS
State : GA
Zip : 30122-1558
Country : US
Telephone Number : 770-941-4529
Fax Number : 770-941-5675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 07/08/2007

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Directions to “ DEANNA SMITH LCSW” Practice Location

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