Individual
DENISE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
289 INDEPENDENCE BLVD, SUITE 312, VIRGINIA BEACH, VA 23462-5493
(757) 385-0684
(757) 493-5456
Mailing address
297 INDEPENDENCE BLVD, SUITE 126, VIRGINIA BEACH, VA 23462-2911
(757) 385-0511
(757) 473-5161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008502
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861562472
—
VA
Enumeration date
09/23/2014
Last updated
09/23/2014
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