Individual
SADIE L SMITH-MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
101 E BROADWAY AVE, BLOOMFIELD, NM 87413-6235
(505) 330-8220
Mailing address
101 E BOADWAY AVE, BLOOMFIELD, NM 87413-5425
(505) 330-8220
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
C-09871
NM
1041C0700X
Clinical Social Worker
Primary
C-09871
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
NM
01
—
1649704925
NPI 2
—
Enumeration date
09/26/2014
Last updated
05/21/2021
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