Healthcare Provider Details

I. General information

NPI: 1790816775
Provider Name (Legal Business Name): LISA ANN SMITH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 N POINT PKWY STE 101
ALPHARETTA GA
30022-1152
US

IV. Provider business mailing address

5755 N POINT PKWY STE 101
ALPHARETTA GA
30022-1152
US

V. Phone/Fax

Practice location:
  • Phone: 678-310-6631
  • Fax: 866-907-3948
Mailing address:
  • Phone: 678-310-6631
  • Fax: 866-907-3948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC003087
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: