Provider Demographics
NPI:1023835725
Name:SMITH, ANGELIA MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANGELIA
Other - Middle Name:MARIE
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6700 WALL ST APT 17C
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-4545
Mailing Address - Country:US
Mailing Address - Phone:251-307-3091
Mailing Address - Fax:251-330-1688
Practice Address - Street 1:4016 SAINT STEPHENS RD
Practice Address - Street 2:
Practice Address - City:WHISTLER
Practice Address - State:AL
Practice Address - Zip Code:36612-1232
Practice Address - Country:US
Practice Address - Phone:251-330-1623
Practice Address - Fax:251-330-1688
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5709G1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical