Provider Demographics
NPI:1912057811
Name:SMITH-PACKARD, MICHELLE R (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:R
Last Name:SMITH-PACKARD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:R
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8 ERIE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-3113
Mailing Address - Country:US
Mailing Address - Phone:508-380-7631
Mailing Address - Fax:
Practice Address - Street 1:340 MAPLE ST
Practice Address - Street 2:ADVOCATES COMMUNITY COUNSELING, 4TH FLOOR
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3200
Practice Address - Country:US
Practice Address - Phone:508-485-9300
Practice Address - Fax:508-485-6904
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1108271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical