Provider Demographics
NPI:1275359390
Name:SMITH, RAMIKA QUANEA (LCSW)
Entity type:Individual
Prefix:
First Name:RAMIKA
Middle Name:QUANEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 TREMONT ST # 324
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-4705
Mailing Address - Country:US
Mailing Address - Phone:617-712-5144
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE # MAIN1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6680
Practice Address - Fax:617-730-0319
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health