Provider Demographics
NPI:1144460437
Name:SMITH, NANCY C (LICSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USAG-J UNIT 45013
Mailing Address - Street 2:B0X 2363
Mailing Address - City:CAMP ZAMA
Mailing Address - State:APO
Mailing Address - Zip Code:AP
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SAMS US ARMY HEALTH CLINIC
Practice Address - Street 2:UNIT 45011 ATTN: MCJA-BHS
Practice Address - City:CAMP ZAMA
Practice Address - State:APO
Practice Address - Zip Code:AP
Practice Address - Country:JP
Practice Address - Phone:0118146-407-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009418091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical