Individual
MRS. ANITA ELLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW, LCADC
Contact information
Practice address
34 SYCAMORE AVE, BUILDING 2, LITTLE SILVER, NJ 07739-1228
(732) 576-8925
(732) 576-8814
Mailing address
34 SYCAMORE AVE, BUILDING 2, LITTLE SILVER, NJ 07739-1228
(732) 576-8925
(732) 576-8814
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00114700
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05447100
NJ
164W00000X
Licensed Practical Nurse
26NP01293900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12173960
CAQH
NJ
Enumeration date
06/21/2007
Last updated
12/30/2010
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