Provider Demographics
NPI:1427365022
Name:MACIAS-SMITH, NANCY (MSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MACIAS-SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTONVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02460-2054
Mailing Address - Country:US
Mailing Address - Phone:617-930-2009
Mailing Address - Fax:
Practice Address - Street 1:89 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEWTONVILLE
Practice Address - State:MA
Practice Address - Zip Code:02460-2054
Practice Address - Country:US
Practice Address - Phone:617-930-2009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3030515104100000X
MA10333103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker