Provider Demographics
NPI:1881197846
Name:SMART, CHERYL SUSAN (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:SUSAN
Last Name:SMART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4830
Mailing Address - Country:US
Mailing Address - Phone:786-208-9552
Mailing Address - Fax:
Practice Address - Street 1:8910 MIRAMAR PKWY # 207-207A
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4100
Practice Address - Country:US
Practice Address - Phone:954-367-2840
Practice Address - Fax:954-505-3378
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW43651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical