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NPI Code Detail

MEDICARE: PRISCILLA SMART-THOMAS LMHC

MEDICARE: PRISCILLA SMART-THOMAS LMHC
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
1101Y00000XCounselor
2101YM0800XMental Health CounselorMH22433FL

General Provider Information

NPI Number : 1518126762
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRISCILLA SMART-THOMAS LMHC
Provider Business Mailing Address
First Line : 119 NW LAKESIDE CT
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-5069
Country : US
Telephone Number : 386-288-7138
Fax Number :
Provider Business Practice Location Address
First Line : 1010 E ROSE ST
Second Line :
City : LAKELAND
State : FL
Zip : 33801-2016
Country : US
Telephone Number : 863-413-3126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2008
Last Update Date : 04/22/2025

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Directions to “ PRISCILLA SMART-THOMAS LMHC” Practice Location

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