Provider Demographics
NPI:1801330147
Name:MACLEOD-SMITH, ERIN (LMSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MACLEOD-SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33539 BALMORAL ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3020
Mailing Address - Country:US
Mailing Address - Phone:734-612-6629
Mailing Address - Fax:734-728-2183
Practice Address - Street 1:33475 PALMER RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4614
Practice Address - Country:US
Practice Address - Phone:734-728-2423
Practice Address - Fax:734-728-2183
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010926211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical