Healthcare Provider Details

I. General information

NPI: 1841106317
Provider Name (Legal Business Name): KIALEN SMITH PLPC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 OLDE OAKS DR
ZACHARY LA
70791-7030
US

IV. Provider business mailing address

1226 OLDE OAKS DR
ZACHARY LA
70791-7030
US

V. Phone/Fax

Practice location:
  • Phone: 414-393-7240
  • Fax:
Mailing address:
  • Phone: 414-393-7240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number767008
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC11415
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: