Provider Demographics
NPI:1326247883
Name:SMITH, FRANKIE LYNN (MSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:FRANKIE
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW, LISW-CP
Other - Prefix:
Other - First Name:FRANKLYN
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LISW-CP
Mailing Address - Street 1:PO BOX 1734
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29465-1734
Mailing Address - Country:US
Mailing Address - Phone:843-696-7895
Mailing Address - Fax:
Practice Address - Street 1:1470 BEN SAWYER BLVD
Practice Address - Street 2:STE. 7
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4591
Practice Address - Country:US
Practice Address - Phone:843-388-2633
Practice Address - Fax:843-388-6990
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1191Medicare PIN