Smith, Larry William
Smith, Larry William is an sole proprietor health care provider with primary practice located at 1071 Crossing Way Nw , Cleveland TN 37312-2867. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Smith, Larry William can be contacted via phone (909) 440-0082.Contact Information
Primary practice address
1071 Crossing Way Nw
Cleveland TN 37312-2867
Phone: (909) 440-0082
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 106859 | California |
Profile Details
| NPI number | 1306366182 |
|---|---|
| LBN Legal business name | Smith, Larry William |
| Credentials | LCSW 106859 |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 22nd, 2017 |
| Last updated | Mar 25th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306366182 | NPPES |
| California | MEDICAID | 1306366182 |
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