Provider Demographics
NPI:1649316282
Name:ARACOMA SMITH, LCSW, PLLC
Entity type:Organization
Organization Name:ARACOMA SMITH, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARACOMA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-361-1844
Mailing Address - Street 1:3715 LATIMERS KNOLL CT STE 103
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7361
Mailing Address - Country:US
Mailing Address - Phone:540-361-1844
Mailing Address - Fax:540-361-1874
Practice Address - Street 1:3715 LATIMERS KNOLL CT STE 103
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7361
Practice Address - Country:US
Practice Address - Phone:540-361-1844
Practice Address - Fax:540-361-1874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10122Medicare PIN