Healthcare Provider Details

I. General information

NPI: 1750201836
Provider Name (Legal Business Name): CALVIN SMITH PHD, ALC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MARKET PL
MONTGOMERY AL
36117-4908
US

IV. Provider business mailing address

2500 EASTERN BLVD BOX 230023
MONTGOMERY AL
36123-0023
US

V. Phone/Fax

Practice location:
  • Phone: 334-315-5893
  • Fax:
Mailing address:
  • Phone: 334-315-5893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberALC06085
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06085
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberALC06085
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: