Provider Demographics
NPI:1932540374
Name:SMITH, SUZANNE M (MA, LCSW)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16877 E FAIR PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5014
Mailing Address - Country:US
Mailing Address - Phone:303-475-2757
Mailing Address - Fax:720-210-9814
Practice Address - Street 1:7600 E ARAPAHOE RD
Practice Address - Street 2:SUITE 305
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1260
Practice Address - Country:US
Practice Address - Phone:303-475-2757
Practice Address - Fax:720-210-9814
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical