Provider Demographics
NPI:1346970811
Name:SMITH, STEPHANIE MAY (LMSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-9776
Mailing Address - Country:US
Mailing Address - Phone:315-519-5724
Mailing Address - Fax:315-493-0105
Practice Address - Street 1:21986 COLE RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-9595
Practice Address - Country:US
Practice Address - Phone:315-493-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker