Provider Demographics
NPI:1790351914
Name:SMITH, NICOLE PATRICIA (MSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:PATRICIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1247
Mailing Address - Country:US
Mailing Address - Phone:774-274-8705
Mailing Address - Fax:
Practice Address - Street 1:1501 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7599
Practice Address - Country:US
Practice Address - Phone:617-847-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical