Provider Demographics
NPI:1255479614
Name:SMITH, CARLA C (CMSW)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 CROSS PARK DR
Mailing Address - Street 2:SUITE E-475
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4506
Mailing Address - Country:US
Mailing Address - Phone:865-560-2579
Mailing Address - Fax:
Practice Address - Street 1:9111 CROSS PARK DR
Practice Address - Street 2:SUITE E-475
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4506
Practice Address - Country:US
Practice Address - Phone:865-560-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN68931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical