Provider Demographics
NPI:1912021965
Name:SMITH, BELINDA (LCSW 70139)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW 70139
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6439 TURNERGROVE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-2706
Mailing Address - Country:US
Mailing Address - Phone:562-234-3207
Mailing Address - Fax:213-840-5754
Practice Address - Street 1:550 S VERMOUNT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELS
Practice Address - State:CA
Practice Address - Zip Code:90020
Practice Address - Country:US
Practice Address - Phone:213-840-5754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA701391041C0700X
CAASW 30267104100000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94915526DOtherHEALTH NET