Carly V Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW010602 Issued in GA

Practice address

1510 Klondike Rd SW Ste 301
Conyers, GA 30094-5121

Phone

(770) 648-1308

Fax

(678) 509-7656

NPI assigned

Mar 23, 2022

Last updated

Sep 28, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1205585544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 KLONDIKE RD SW STE 301",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945121",
            "telephone_number": "770-648-1308",
            "fax_number": "678-509-7656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Gwinnett Dr",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300468444",
            "country_code": "US",
            "telephone_number": "678-209-2394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARLY",
        "middle_name": "V",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW010602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexis Smith
• Crystal M Smith
• Danyelle M Smith, FNP
• Ethel L Smith, MD
• Eulanda S Smith
• Harmon Andrew Smith, M.D.

• Clinical Social Worker in Conyers, GA
• Providers in Conyers, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.