Provider Demographics
NPI:1871205377
Name:SMITH, SHERITA E (LMSW)
Entity type:Individual
Prefix:
First Name:SHERITA
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-2152
Mailing Address - Country:US
Mailing Address - Phone:816-200-6001
Mailing Address - Fax:
Practice Address - Street 1:7840 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1751
Practice Address - Country:US
Practice Address - Phone:816-200-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020013671104100000X
KS11656104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker