Provider Demographics
NPI:1033899414
Name:SMITH, NA'KIRRA (RCSWI)
Entity Type:Individual
Prefix:
First Name:NA'KIRRA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33897-7772
Mailing Address - Country:US
Mailing Address - Phone:919-333-8073
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:221 ANDOVER DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33897-7772
Practice Address - Country:US
Practice Address - Phone:919-333-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW190701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical