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NPI Code Detail

MEDICARE: BRANDY SHAWN SMITH LCPC

MEDICARE: BRANDY SHAWN SMITH LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor03958KS
2101YP2500XProfessional Counselor3559KS

General Provider Information

NPI Number : 1366160459
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY SHAWN SMITH LCPC
Provider Business Mailing Address
First Line : 3115 S 54TH ST
Second Line :
City : KANSAS CITY
State : KS
Zip : 66106-3217
Country : US
Telephone Number : 913-302-6844
Fax Number :
Provider Business Practice Location Address
First Line : 3115 S 54TH ST
Second Line :
City : KANSAS CITY
State : KS
Zip : 66106-3217
Country : US
Telephone Number : 913-302-6844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2022
Last Update Date : 07/23/2025

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Directions to “ BRANDY SHAWN SMITH LCPC” Practice Location

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