| Carrie Louise Smith, LCSW | |
|
4700 Enterprise Way, Modesto, CA 95356 | |
| (209) 550-6013 | |
| Not Available |
| Full Name | Carrie Louise Smith |
|---|---|
| Gender | Female |
| Speciality | Counselor |
| Location | 4700 Enterprise Way, Modesto, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316160864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (NU) | Primary |
| 1041C0700X | Social Worker - Clinical | LCSW87808 (California) | Secondary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Carrie Louise Smith, LCSW 218 Delta Ave, Brentwood, CA 94513-1603 Ph: (209) 550-6013 | Carrie Louise Smith, LCSW 4700 Enterprise Way, Modesto, CA 95356 Ph: (209) 550-6013 |
Virginia A. Horton, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2020 Coffee Road, Suite H-4, Modesto, CA 95355 Phone: 209-613-4255 Fax: 209-567-1015 |
Mrs. Jessica Nelson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1620 Cummins Dr, Modesto, CA 95358 Phone: 209-622-1420 |
Edelya Silva, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1620 Cummins Dr, Modesto, CA 95358 Phone: 209-576-1750 |
Crystal A Gonzalez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 121 Downey Ave, Modesto, CA 95354 Phone: 209-341-1824 |
Chase Fetzer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 W Briggsmore Ave, Modesto, CA 95350 Phone: 209-526-1476 |
Nereida Lomeli, MFT-I Counselor Medicare: Not Enrolled in Medicare Practice Location: 1800 Tully Rd, Ste F, Modesto, CA 95350 Phone: 209-576-1750 Fax: 209-576-1768 |
Cynthia Marie Mccleary, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1620 Cummins Dr, Modesto, CA 95358 Phone: 209-622-1420 |