Provider Demographics
NPI:1124228531
Name:SMITH, NESSA LYNN (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:NESSA
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:NESSA
Other - Middle Name:L
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:143 E WALLACE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-2453
Mailing Address - Country:US
Mailing Address - Phone:724-654-9555
Mailing Address - Fax:724-498-0976
Practice Address - Street 1:143 E WALLACE AVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-2453
Practice Address - Country:US
Practice Address - Phone:724-654-9555
Practice Address - Fax:724-498-0976
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0153521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical