Provider Demographics
NPI:1952987125
Name:SMART, LAURA B (LGSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:SMART
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6702 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MORNINGSIDE
Mailing Address - State:MD
Mailing Address - Zip Code:20746-3506
Mailing Address - Country:US
Mailing Address - Phone:240-277-7851
Mailing Address - Fax:
Practice Address - Street 1:6702 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:MORNINGSIDE
Practice Address - State:MD
Practice Address - Zip Code:20746-3506
Practice Address - Country:US
Practice Address - Phone:240-277-7851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50082901104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker