Individual
MR. AMASA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
121 NORTH STREET, #405, HINGHAM, MA 02043-9970
(617) 807-0077
Mailing address
121 NORTH STREET, #405, HINGHAM, MA 02043-9970
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
09925111
CO
1041C0700X
Clinical Social Worker
Primary
122577
MA
1041C0700X
Clinical Social Worker
—
—
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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