Provider Demographics
NPI:1952758161
Name:SMITH, DONNITA TAYLOR (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:DONNITA
Middle Name:TAYLOR
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MS
Other - First Name:DONNITA
Other - Middle Name:JENEEN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:357 S KRAMER PATH
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-3799
Mailing Address - Country:US
Mailing Address - Phone:919-798-3997
Mailing Address - Fax:
Practice Address - Street 1:357 S KRAMER PATH
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27527-3799
Practice Address - Country:US
Practice Address - Phone:919-798-3997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0144601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical