Provider Demographics
NPI:1144365743
Name:SMALLS, MARGARET YVONNE (LMSW)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:YVONNE
Last Name:SMALLS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2474 DAVIDSON AVE
Mailing Address - Street 2:APARTMENT 4F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-5318
Mailing Address - Country:US
Mailing Address - Phone:646-643-3119
Mailing Address - Fax:
Practice Address - Street 1:506 MALCOLM X BLVD
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070288-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246108Medicaid