Provider Demographics
NPI:1265725832
Name:SMITH, KATHERINE LAWSON (LMSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LAWSON
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 WOODSIDE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2638
Mailing Address - Country:US
Mailing Address - Phone:303-563-9500
Mailing Address - Fax:
Practice Address - Street 1:29551 GREENFIELD RD STE 208
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5872
Practice Address - Country:US
Practice Address - Phone:248-744-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011023431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical