Provider Demographics
NPI:1265450555
Name:SMITH, MARGIE SUE (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:MARGIE
Middle Name:SUE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:MARGIE
Other - Middle Name:SUE
Other - Last Name:FURMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:147 W GRAY ST STE 111
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3017
Mailing Address - Country:US
Mailing Address - Phone:607-731-3881
Mailing Address - Fax:
Practice Address - Street 1:147 W GRAY ST STE 111
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3017
Practice Address - Country:US
Practice Address - Phone:607-731-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR060354-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical