Individual
DESARAY SMITH
Active
Individual
DESARAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22730
MD
1041C0700X
Clinical Social Worker
C006751
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183C6
BCBS
NC
05
—
6007560
—
NC
Enumeration date
04/05/2010
Last updated
09/21/2021
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