Individual
MADISON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
760 N MOTEL BLVD, LAS CRUCES, NM 88007-4169
(575) 527-7975
(575) 674-2861
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-12202
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16252730
—
NM
Enumeration date
09/01/2017
Last updated
10/10/2022
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