Provider Demographics
NPI:1992236491
Name:SMITH, JAMIE SHEA (LCSW, LCASA)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:SHEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6508 DEER POINTE DR STE 4C
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1668
Mailing Address - Country:US
Mailing Address - Phone:410-742-6016
Mailing Address - Fax:410-742-6014
Practice Address - Street 1:6508 DEER POINTE DR STE 4C
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1668
Practice Address - Country:US
Practice Address - Phone:410-742-6016
Practice Address - Fax:410-742-6014
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-26
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD255721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty