Individual
REBECCA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
200 VETERANS AVE, BECKLEY, WV 25801-6444
(304) 255-2121
Mailing address
131 FERN LN, BECKLEY, WV 25801-8382
(304) 731-9444
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00941912
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005489001
—
WV
05
—
0005489002
—
WV
Enumeration date
05/11/2017
Last updated
02/24/2023
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