Provider Demographics
NPI:1134303357
Name:SMITH, SCARLET F (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SCARLET
Middle Name:F
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 690
Mailing Address - Street 2:
Mailing Address - City:BEATTYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41311-0690
Mailing Address - Country:US
Mailing Address - Phone:606-464-0151
Mailing Address - Fax:606-464-0151
Practice Address - Street 1:38 J F GREEN ST
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:KY
Practice Address - Zip Code:41171-7134
Practice Address - Country:US
Practice Address - Phone:606-738-5545
Practice Address - Fax:606-738-5405
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35631041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100280740Medicaid
11826720OtherCAQH #
000000747275OtherANTHEM BCBS
11826720OtherCAQH #
OH$$$$$$$$$-00OtherBWC-OHIO WORKERS COMPENSATION