Provider Demographics
NPI:1609111871
Name:SMITH, MARGARET S (CSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 S 400 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2135
Mailing Address - Country:US
Mailing Address - Phone:801-595-0666
Mailing Address - Fax:801-595-0669
Practice Address - Street 1:124 S 400 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2135
Practice Address - Country:US
Practice Address - Phone:801-595-0666
Practice Address - Fax:801-595-0669
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8320352-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical