Provider Demographics
NPI:1235573072
Name:SMITH, CARRIE JOY (MSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:JOY
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 DALY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-3309
Mailing Address - Country:US
Mailing Address - Phone:323-226-4448
Mailing Address - Fax:
Practice Address - Street 1:1925 DALY ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-3309
Practice Address - Country:US
Practice Address - Phone:323-226-4448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical