Provider Demographics
NPI:1427694330
Name:SMITH, JOSEPH (MSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 MASSAPONAX CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-8778
Mailing Address - Country:US
Mailing Address - Phone:540-834-4569
Mailing Address - Fax:
Practice Address - Street 1:3412 MASSAPONAX CHURCH RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-8778
Practice Address - Country:US
Practice Address - Phone:540-834-4569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool