Male or Other

Mr. Michael Smith LICSW

Clinical Social Worker in Worcester, MA(View on Map)

Full Name

Mr. Michael Smith LICSW

NPI Number

1598707374

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/13/2006

Specialties

(Taxonomies)

Code

1041C0700X

Primary Taxonomy

Yes

Licenses

State

Massachusetts
Rhode Island
Rhode Island

License Number

117423
CSW00841
ISW01811

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 415348
291 LINCOLN ST

City

Boston
Worcester

State

MA
MA

Postal Code

02241
01605-3643

Country

US
US

Telephone Number

(401) 524-8027
(508) 334-3240

Identifiers

Identifier

MS59551
1020890

Identifier State

RI
RI

Identifier Issuer

Unknown
BEACON/NHP

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/10/2015

Provider Address

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