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NPI Code Detail

MEDICARE: VICKI B SMITH LPC

MEDICARE: VICKI B 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
1101YP2500XProfessional Counselor003689GA

General Provider Information

NPI Number : 1588794663
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI B SMITH LPC
Provider Business Mailing Address
First Line : 1788 CENTURY BLVD NE STE B
Second Line :
City : ATLANTA
State : GA
Zip : 30345-3321
Country : US
Telephone Number : 404-386-1896
Fax Number :
Provider Business Practice Location Address
First Line : 1788 CENTURY BLVD NE STE B
Second Line :
City : ATLANTA
State : GA
Zip : 30345-3321
Country : US
Telephone Number : 404-386-1896
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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Directions to “ VICKI B SMITH LPC” Practice Location

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