Provider Demographics
NPI:1558436444
Name:SMITH, LASHAWN E (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LASHAWN
Middle Name:E
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 1:17900 LINDEN BLVD
Mailing Address - Street 2:PRIMARY CARE S131
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11425-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 W KINGSBRIDGE RD
Practice Address - Street 2:MHPCC
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3904
Practice Address - Country:US
Practice Address - Phone:718-584-9000
Practice Address - Fax:718-741-4709
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072130-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker