Provider Demographics
NPI:1689133274
Name:SMITH, HAROLD EDMOND (MSW U/S, LMSW)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:EDMOND
Last Name:SMITH
Suffix:
Gender:M
Credentials:MSW U/S, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1105
Mailing Address - Country:US
Mailing Address - Phone:918-610-3366
Mailing Address - Fax:918-610-3344
Practice Address - Street 1:3445 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1105
Practice Address - Country:US
Practice Address - Phone:918-610-3366
Practice Address - Fax:918-610-3344
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical