Provider Demographics
NPI:1922887694
Name:HAYWOOD SMITH, MAISHA (LCSW, DBH)
Entity type:Individual
Prefix:DR
First Name:MAISHA
Middle Name:
Last Name:HAYWOOD SMITH
Suffix:
Gender:F
Credentials:LCSW, DBH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4179
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-4179
Mailing Address - Country:US
Mailing Address - Phone:530-400-1425
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 4179
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95617-4179
Practice Address - Country:US
Practice Address - Phone:530-400-1425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11797781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical