Healthcare Provider Details

I. General information

NPI: 1669950432
Provider Name (Legal Business Name): RINDA JO SMITH LSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 N END TRL
TABOR CITY NC
28463-5300
US

IV. Provider business mailing address

27 N END TRL
TABOR CITY NC
28463-5300
US

V. Phone/Fax

Practice location:
  • Phone: 256-497-4790
  • Fax:
Mailing address:
  • Phone: 256-497-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP021814
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: