Provider Demographics
NPI:1639421407
Name:SMITH, ALICIA DARLENE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:DARLENE
Last Name:SMITH
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:DARLENE
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1125 LAUREN WAY NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-3887
Mailing Address - Country:US
Mailing Address - Phone:423-255-2357
Mailing Address - Fax:
Practice Address - Street 1:1 EMERSON PL STE 3H
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2252
Practice Address - Country:US
Practice Address - Phone:339-666-8516
Practice Address - Fax:617-807-0958
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW11406581041C0700X
GACSW0047491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical