Healthcare Provider Details

I. General information

NPI: 1093667560
Provider Name (Legal Business Name): CARRIE LYNN SMITH PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 NORRIS AVE
MC COOK NE
69001-3140
US

IV. Provider business mailing address

1103 9TH ST
ARAPAHOE NE
68922-2749
US

V. Phone/Fax

Practice location:
  • Phone: 308-345-4067
  • Fax:
Mailing address:
  • Phone: 308-991-1430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14786
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: