Provider Demographics
NPI:1831267855
Name:SMITH, TREVOR HEYWARD
Entity type:Individual
Prefix:MR
First Name:TREVOR
Middle Name:HEYWARD
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BEVERLY RD
Mailing Address - Street 2:APT 203
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1544
Mailing Address - Country:US
Mailing Address - Phone:412-737-3797
Mailing Address - Fax:
Practice Address - Street 1:374 LAWN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-4214
Practice Address - Country:US
Practice Address - Phone:412-246-1615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130416104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker