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NPI Code Detail

MEDICARE: MRS. RACHELLE D SMITH PHD, LPC

MEDICARE: MRS. RACHELLE D SMITH PHD, 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
1101YP2500XProfessional Counselor2010009689MO

General Provider Information

NPI Number : 1558682930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RACHELLE D SMITH PHD, LPC
Provider Business Mailing Address
First Line : 9100 OVERLAND PLZ
Second Line :
City : OVERLAND
State : MO
Zip : 63114-6123
Country : US
Telephone Number : 314-744-9027
Fax Number : 314-571-9698
Provider Business Practice Location Address
First Line : 9100 OVERLAND PLZ
Second Line :
City : OVERLAND
State : MO
Zip : 63114-6123
Country : US
Telephone Number : 314-744-9027
Fax Number : 314-571-9698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2010
Last Update Date : 06/13/2016

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