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NPI Code Detail

MEDICARE: CHARLOTTE SMITH LPC

MEDICARE: CHARLOTTE 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 Counselor71089TX

General Provider Information

NPI Number : 1720546229
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLOTTE SMITH LPC
Provider Business Mailing Address
First Line : 9090 SKILLMAN STREET, STE 182A
Second Line : BOX #220
City : DALLAS
State : TX
Zip : 75243
Country : US
Telephone Number : 480-200-0498
Fax Number :
Provider Business Practice Location Address
First Line : 6060 N CENTRAL EXPY STE 500
Second Line :
City : DALLAS
State : TX
Zip : 75206-5249
Country : US
Telephone Number : 480-200-0498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2019
Last Update Date : 05/06/2026

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