Individual
SAMANTHA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1110 GRAND AVE, JACKSON, MS 39203-2505
(601) 339-0032
Mailing address
1001 CHERRY STONE CIR, CLINTON, MS 39056-2027
(601) 910-1676
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110276
TX
1041C0700X
Clinical Social Worker
C9038
MS
Other
Enumeration date
07/01/2021
Last updated
07/19/2024
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