Provider Demographics
NPI:1679715502
Name:SMITH, CAROLYN BOWDEN (LICSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BOWDEN
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 1:9224 ROLLING VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2458
Mailing Address - Country:US
Mailing Address - Phone:301-306-0185
Mailing Address - Fax:
Practice Address - Street 1:2570 SHERMAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2299
Practice Address - Country:US
Practice Address - Phone:202-232-6100
Practice Address - Fax:202-483-4560
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3014251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical