Individual
STACEY CHARLENE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2199 PHILLIPSBURG RD, DAMASCUS, GA 39841-2009
(318) 302-1053
Mailing address
2199 PHILLIPSBURG RD, DAMASCUS, GA 39841-2009
(318) 302-1053
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
11176
LA
1041C0700X
Clinical Social Worker
Primary
CSW006018
GA
Other
Enumeration date
03/27/2017
Last updated
04/28/2026
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