Individual
PETER JOSEPH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD LCSW C
Contact information
Practice address
5407 N CHARLES STREET, BALTIMORE, MD 21210-2024
(410) 433-8861
(410) 433-1249
Mailing address
5407 N CHARLES STREET, BALTIMORE, MD 21210-2024
(410) 433-8861
(410) 433-1249
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
06728
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009
FED BC
—
01
—
481448000
MAGELLAN
—
01
—
52282101
BCBS
MD
Enumeration date
07/11/2006
Last updated
09/23/2011
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