Healthcare Provider Details
I. General information
NPI: 1235281106
Provider Name (Legal Business Name): CHERI L SMITH M ED, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 12/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4238 AUBURN WAY N
AUBURN WA
98002-1311
US
IV. Provider business mailing address
1600 E OLIVE ST SOUND MENTAL HEALTH
SEATTLE WA
98122-2735
US
V. Phone/Fax
- Phone: 253-876-7600
- Fax: 253-876-7610
- Phone: 206-302-2200
- Fax: 206-302-2210
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | CP60387426 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LH00009166 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: