Provider Demographics
NPI:1639325509
Name:SMITH, DARRYL GREEN (MSW, GSW)
Entity Type:Individual
Prefix:MRS
First Name:DARRYL
Middle Name:GREEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW, GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 PHILIP ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-2525
Mailing Address - Country:US
Mailing Address - Phone:504-568-6650
Mailing Address - Fax:504-568-4667
Practice Address - Street 1:2221 PHILIP ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-2525
Practice Address - Country:US
Practice Address - Phone:504-568-6650
Practice Address - Fax:504-568-4667
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA53581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical