Provider Demographics
NPI:1093910648
Name:SMITH, DAVID (LCSW, LICSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SMITH
Suffix:
Gender:U
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W 35TH ST STE 500-1032
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2507
Mailing Address - Country:US
Mailing Address - Phone:347-212-0512
Mailing Address - Fax:
Practice Address - Street 1:224 W 35TH ST STE 500-1032
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2507
Practice Address - Country:US
Practice Address - Phone:347-212-0512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73 0819341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical