Individual
CASSONDRA NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
723 MASSACHUSETTS AVE, BOSTON, MA 02118-2318
(617) 534-9500
Mailing address
1010 MASSACHUSETTS AVE, BOSTON, MA 02118-2600
(617) 419-3408
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
119726
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110122549A
—
MA
Enumeration date
10/04/2010
Last updated
04/15/2024
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