Provider Demographics
NPI:1619238938
Name:SMITH, NATALIE LYN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:LYN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 W PENN AVE
Mailing Address - Street 2:APT 4
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-1420
Mailing Address - Country:US
Mailing Address - Phone:610-413-9280
Mailing Address - Fax:
Practice Address - Street 1:351 W PENN AVE
Practice Address - Street 2:APT 4
Practice Address - City:WERNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19565-1420
Practice Address - Country:US
Practice Address - Phone:610-413-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128768104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker