Healthcare Provider Details

I. General information

NPI: 1699976050
Provider Name (Legal Business Name): REBECCA LEIGH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S. 48TH STREET
SPRINDALE AR
72762
US

IV. Provider business mailing address

2400 S 48TH ST
SPRINGDALE AR
72762-6683
US

V. Phone/Fax

Practice location:
  • Phone: 479-443-7105
  • Fax: 479-443-2519
Mailing address:
  • Phone: 479-750-2020
  • Fax: 479-750-8967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP0503015
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17366
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10002049
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: