Healthcare Provider Details

I. General information

NPI: 1780618454
Provider Name (Legal Business Name): LUCINA V SMITH-BROOKS PH.D, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2319 ST MATTHEWS ROAD
ORANGEBURG SC
29118
US

IV. Provider business mailing address

153 CRANBROOK CT
GASTON SC
29053-8112
US

V. Phone/Fax

Practice location:
  • Phone: 803-536-1571
  • Fax: 803-536-1463
Mailing address:
  • Phone: 803-402-4047
  • Fax: 803-402-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: