Provider Demographics
NPI:1487460556
Name:SMITH, STEPHANY (LCSW-C)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-2971
Mailing Address - Country:US
Mailing Address - Phone:027-575-3193
Mailing Address - Fax:
Practice Address - Street 1:106 E MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5780
Practice Address - Country:US
Practice Address - Phone:410-443-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD245901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical