Provider Demographics
NPI:1922887694
Name:HAYWOOD SMITH, MAISHA (LCSW, DBH)
Entity Type:Individual
Prefix:DR
First Name:MAISHA
Middle Name:
Last Name:HAYWOOD SMITH
Suffix:
Gender:F
Credentials:LCSW, DBH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 REINHOLZ AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-8587
Mailing Address - Country:US
Mailing Address - Phone:209-668-2905
Mailing Address - Fax:
Practice Address - Street 1:4405 REINHOLZ AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-8587
Practice Address - Country:US
Practice Address - Phone:209-668-2905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11797781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical