Provider Demographics
NPI:1417639345
Name:SMITH BARIL, DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SMITH BARIL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11115 OLD BICYCLE RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-2621
Mailing Address - Country:US
Mailing Address - Phone:850-774-1132
Mailing Address - Fax:
Practice Address - Street 1:11115 OLD BICYCLE RD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-2621
Practice Address - Country:US
Practice Address - Phone:850-774-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW201521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical