Provider Demographics
NPI:1013314921
Name:SMITH, BOBETTE N (LCSW)
Entity Type:Individual
Prefix:
First Name:BOBETTE
Middle Name:N
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:BOBETTE
Other - Middle Name:N
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7118 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WADE
Mailing Address - State:NC
Mailing Address - Zip Code:28395
Mailing Address - Country:US
Mailing Address - Phone:910-483-6694
Mailing Address - Fax:
Practice Address - Street 1:7250 SANDCASTLE LN
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NC
Practice Address - Zip Code:28356-9437
Practice Address - Country:US
Practice Address - Phone:910-489-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0089851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical