Shawn Angelique Smith | Staten Island, NY • PECOS Search

Shawn Angelique Smith

Social Worker

Behavioral Health & Social Service Providers

56 Beach St, Staten Island, NY 10304-2702

(718) 720-2603 (347) 977-3269

PECOS Enrollment

Based on the most recent information from CMS, provider Shawn Angelique Smith does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1467879197
Provider Type
Individual
Full Name
Smith, Shawn Angelique
Title
Ms.
Credential
LMSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/19/2014
Last Updated
3/19/2014

Contact Information

Practice Location

56 Beach St, Staten Island, NY 10304-2702

Unlisted Fax

Mailing Location

1438 Noah Rd, North Brunswick, NJ 08902-1345

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 080800-1 New York