Provider Demographics
NPI:1578915153
Name:SMITH, LA KIA MONIQUE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LA KIA
Middle Name:MONIQUE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 5TH ST NW APT 201
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-4870
Mailing Address - Country:US
Mailing Address - Phone:202-520-9501
Mailing Address - Fax:
Practice Address - Street 1:1315 5TH ST NW APT 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4870
Practice Address - Country:US
Practice Address - Phone:202-520-9501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500798671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical