Healthcare Provider Details

I. General information

NPI: 1194595173
Provider Name (Legal Business Name): JAMIE SMITH LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 LOCUST ST STE 331
DOVER NH
03820-3753
US

IV. Provider business mailing address

PO BOX 148
CAMPTON NH
03223-0148
US

V. Phone/Fax

Practice location:
  • Phone: 603-740-3534
  • Fax: 603-740-3684
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2697
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0135633
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: