Provider Demographics
NPI:1588803779
Name:SMITH, VERONICA LABRELL (LMSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:LABRELL
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 1:10422 TERRACO DR
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20623-1201
Mailing Address - Country:US
Mailing Address - Phone:509-247-8410
Mailing Address - Fax:
Practice Address - Street 1:11400 GLENN DALE BLVD
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9049
Practice Address - Country:US
Practice Address - Phone:301-352-1768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010852241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical