Provider Demographics
NPI:1982164687
Name:SMITH, ALYSSA JEAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:JEAN
Other - Last Name:MARMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:205 HORACE MANN DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-1225
Mailing Address - Country:US
Mailing Address - Phone:973-626-0308
Mailing Address - Fax:
Practice Address - Street 1:2000 GLEN ECHO RD STE 204
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2898
Practice Address - Country:US
Practice Address - Phone:973-626-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN92051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical