Individual
KALISHA DENEA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
500 N BRIDGE ST, BRIDGEWATER, NJ 08807-2135
(908) 725-2800
(908) 704-1790
Mailing address
500 N BRIDGE ST, BRIDGEWATER, NJ 08807-2135
(908) 725-2800
(908) 704-1790
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023701
AGENCY MAIN MEDICAID PROVIDER NUMBER
NJ
01
—
8363102
AGENCY MEDICARE PROVIDER # FOR CASE MANAGEMENT
NJ
Enumeration date
12/12/2012
Last updated
12/12/2012
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