Provider Demographics
NPI:1124185152
Name:SMITH, CHRISTOPHER PHILLIP (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PHILLIP
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 BROWNING RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1738
Mailing Address - Country:US
Mailing Address - Phone:412-665-0506
Mailing Address - Fax:
Practice Address - Street 1:1900 MURRAY AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1657
Practice Address - Country:US
Practice Address - Phone:412-956-3482
Practice Address - Fax:412-421-2750
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW005402E1041C0700X
PACW0160851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA286363OtherHIGHMARK PROVIDER NUMBER
PA218644OtherUPMC