Provider Demographics
NPI:1326931270
Name:SMITH, MICHAELA DAVIDA (MSW)
Entity type:Individual
Prefix:MISS
First Name:MICHAELA
Middle Name:DAVIDA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-2582
Mailing Address - Country:US
Mailing Address - Phone:470-213-7769
Mailing Address - Fax:
Practice Address - Street 1:15 FAIRGROUND RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:GA
Practice Address - Zip Code:30648-2034
Practice Address - Country:US
Practice Address - Phone:706-788-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker