Provider Demographics
NPI:1821725474
Name:SMITH, PETER REEVES (MS, MSW, LSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:REEVES
Last Name:SMITH
Suffix:
Gender:M
Credentials:MS, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LEWIS BROOK RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-1909
Mailing Address - Country:US
Mailing Address - Phone:908-528-4015
Mailing Address - Fax:
Practice Address - Street 1:1 MONUMENT DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3036
Practice Address - Country:US
Practice Address - Phone:609-924-8018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00373800101YA0400X
NJ44SL06822000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)