Provider Demographics
NPI:1841329679
Name:MARIECIA YVETTE SMITH
Entity type:Organization
Organization Name:MARIECIA YVETTE SMITH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN SERVICES SENIOR PRACTITIONER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:919-250-3133
Mailing Address - Street 1:118 HIDDEN OAKS DR APT 1A
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3391
Mailing Address - Country:US
Mailing Address - Phone:919-771-4481
Mailing Address - Fax:
Practice Address - Street 1:3000 FALSTAFF RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1813
Practice Address - Country:US
Practice Address - Phone:919-250-3133
Practice Address - Fax:919-250-1176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0055631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty