Most Relevant Information
Provider Data
| NPI Number: | 1003465675 |
| Provider Name: | SHANE R SMITH LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 12469 |
Most Important Dates
| Enumeration Date: | 09/06/2019 |
| Last Updated: | 09/06/2019 |
Provider Practice Location
403 STONY LANDING RD
MONCKS CORNER
SC
294613967
Practice Location Phone/Fax
| Phone: | 8437618282 |
| Fax: | 8437617308 |
Provider Mailing Location
403 STONY LANDING RD
MONCKS CORNER
SC
294613967
Provider Mailing Phone/Fax
| Phone: | 8437618282 |
| Fax: | 8437617308 |