Provider Demographics
NPI:1275621336
Name:SMITH, FLOYD P (LCSW)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:P
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 ST CHARLES ROCK ROAD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114
Mailing Address - Country:US
Mailing Address - Phone:314-427-3755
Mailing Address - Fax:314-426-0764
Practice Address - Street 1:8240 ST CHARLES ROCK ROAD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114
Practice Address - Country:US
Practice Address - Phone:314-427-3755
Practice Address - Fax:314-426-0764
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW004101104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker