| Sally Smirthwaite, Lcsw, Pllc | |
|
8990 Lorraine Rd Gulfport MS 39503-4176 | |
| (228) 331-3310 | |
| Not Available |
| Full Name | Sally Smirthwaite, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 8990 Lorraine Rd, Gulfport, Mississippi |
| Authorized Official Name and Position | Sarah Smirthwaite (OWNER/LCSW) |
| Authorized Official Contact | 2283827264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally Smirthwaite, Lcsw, Pllc 8990 Lorraine Rd Gulfport MS 39503-4176 Ph: (228) 331-3310 | Sally Smirthwaite, Lcsw, Pllc 8990 Lorraine Rd Gulfport MS 39503-4176 Ph: (228) 331-3310 |
| NPI Number | 1063094712 |
|---|---|
| Provider Enumeration Date | 04/22/2021 |
| Last Update Date | 04/22/2021 |
| Certification Date | 04/22/2021 |
| Medicare PECOS PAC ID | 2769881630 |
|---|---|
| Medicare Enrollment ID | O20210526000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063094712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sarah Suzanne Smirthwaite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427420108 PECOS PAC ID: 0648570572 Enrollment ID: I20151130000234 |
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