Provider Demographics
NPI:1942019716
Name:SMITH, TANYA CHIKIRA (LMSW)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:CHIKIRA
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 1:110 STONEFIELD DR APT 7
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-3322
Mailing Address - Country:US
Mailing Address - Phone:203-805-2535
Mailing Address - Fax:
Practice Address - Street 1:541 WOLCOTT ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-1334
Practice Address - Country:US
Practice Address - Phone:203-591-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10518104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker