Individual
MR. LARRY WILLIAM SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW 106859
Contact information
Practice address
5046 SKYLINE WAY NE, CLEVELAND, TN 37312-2492
(909) 440-0082
Mailing address
5046 SKYLINE WAY NE, CLEVELAND, TN 37312-2492
(909) 440-0082
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
016507
CT
1041C0700X
Clinical Social Worker
0904019034
VA
1041C0700X
Clinical Social Worker
Primary
106859
CA
1041C0700X
Clinical Social Worker
12697-C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306366182
—
CA
05
—
1306366182
—
CT
05
—
1306366182
—
NV
05
—
1306366182
—
VA
Enumeration date
06/22/2017
Last updated
05/15/2026
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