Provider Demographics
NPI:1811697220
Name:SMITH, SHA'NECE N (LCSW)
Entity type:Individual
Prefix:
First Name:SHA'NECE
Middle Name:N
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 1:5656 OAK RUN LN
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-1939
Mailing Address - Country:US
Mailing Address - Phone:609-969-2379
Mailing Address - Fax:
Practice Address - Street 1:4907 FITZHUGH AVE STE 202
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3533
Practice Address - Country:US
Practice Address - Phone:804-464-8340
Practice Address - Fax:804-884-3726
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040149301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical