Provider Demographics
NPI:1134411994
Name:SMITH, SHILO CARAMAY (LCSW)
Entity type:Individual
Prefix:MISS
First Name:SHILO
Middle Name:CARAMAY
Last Name:SMITH
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 1:546 SE 204TH PL
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-2300
Mailing Address - Country:US
Mailing Address - Phone:315-373-3900
Mailing Address - Fax:
Practice Address - Street 1:331 SE 2ND ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2224
Practice Address - Country:US
Practice Address - Phone:541-276-6207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR49581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical