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Individual

SHIRLEY J SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1100 S MINT ST, STE 101, CHARLOTTE, NC 28203-4049
(704) 379-1850
(704) 335-1395
Mailing address
1100 S MINT ST, STE 101, CHARLOTTE, NC 28203-4049
(704) 379-1850
(704) 335-1395

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
C001183
NC
104100000X
Social Worker
Primary
C001183
NC
1041C0700X
Clinical Social Worker
C001183
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6006204
NC
05
6006205
NC
Enumeration date
11/03/2009
Last updated
03/19/2010
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