MEDICARE: KRISTEN J SMITH LPC

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
1	101YP2500X	Professional Counselor	P2411015	AR

General Provider Information

NPI Number	:	1386350551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN J SMITH LPC

Provider Business Mailing Address
First Line	:	1517 CALDWELL ST STE 2
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-5240
Country	:	US
Telephone Number	:	501-382-8320
Fax Number	:	501-904-8173

Provider Business Practice Location Address
First Line	:	1517 CALDWELL ST STE 2
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-5240
Country	:	US
Telephone Number	:	501-382-8320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	08/27/2025

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Directions to “ KRISTEN J SMITH LPC” Practice Location

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