Provider Demographics
NPI:1194075804
Name:SMITH, CELIA H (MSW)
Entity type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:H
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:CELIA
Other - Middle Name:H
Other - Last Name:TANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1135 MORTON ST
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2834
Mailing Address - Country:US
Mailing Address - Phone:617-533-2400
Mailing Address - Fax:617-533-2301
Practice Address - Street 1:1135 MORTON ST
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2834
Practice Address - Country:US
Practice Address - Phone:617-533-2400
Practice Address - Fax:617-533-2301
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker