Provider Demographics
NPI:1558520304
Name:SMITH, KATHRYN E (LCSW, LICSW, MSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW, LICSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-0159
Mailing Address - Country:US
Mailing Address - Phone:207-551-5344
Mailing Address - Fax:
Practice Address - Street 1:21 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2843
Practice Address - Country:US
Practice Address - Phone:207-768-3168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MEMC116341041C0700X
MA1255551041C0700X
NHLC129931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical