Individual
MR. AMASA SMITH
Active
Individual
MR. AMASA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
09925111
CO
1041C0700X
Clinical Social Worker
Primary
122577
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09925111
LICENSED CLINICAL SOCIAL WORKER
CO
01
—
122577
LICENSED CLINICAL SOCIAL WORKER
MA
01
—
ISW03251
LICENSED INDEPENDENT CLINICAL SOCIAL WORKER
RI
Enumeration date
12/12/2019
Last updated
12/04/2023
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