Provider Demographics
NPI:1386310241
Name:SMITH, OMEGA ANN (MSW)
Entity type:Individual
Prefix:
First Name:OMEGA
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44335 PREMIER PLZ STE 230
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5052
Mailing Address - Country:US
Mailing Address - Phone:571-498-0109
Mailing Address - Fax:
Practice Address - Street 1:44335 PREMIER PLZ STE 230
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5052
Practice Address - Country:US
Practice Address - Phone:571-498-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical