Healthcare Provider Details

I. General information

NPI: 1699351247
Provider Name (Legal Business Name): RASHADA CAMILLE SMITH LPC,NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 PELHAM RD S STE 7
JACKSONVILLE AL
36265-3707
US

IV. Provider business mailing address

1007 ALEXANDRIA RD SW LOT 36
JACKSONVILLE AL
36265-3042
US

V. Phone/Fax

Practice location:
  • Phone: 256-365-8686
  • Fax: 919-590-1895
Mailing address:
  • Phone: 205-835-3029
  • Fax: 919-590-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4361
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: