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Individual
TRACI A SMITH
Active
Individual
TRACI A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16623
SC
1041C0700X
Clinical Social Worker
C017432
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
09/13/2017
Last updated
08/21/2024
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