Individual
MR. BERNARD A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4 COMMERCE LN, CANTON, NY 13617-3739
(315) 386-8191
(315) 386-1410
Mailing address
4 COMMERCE LN, CANTON, NY 13617-3739
(315) 386-8191
(315) 386-1410
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R057519
NY
1041C0700X
Clinical Social Worker
R057519-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01995615
—
NY
Enumeration date
04/07/2010
Last updated
09/24/2013
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