Healthcare Provider Details

I. General information

NPI: 1558110163
Provider Name (Legal Business Name): STEPHANIE MARIE SMITH LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 MISSION AVE STE 211
CASHMERE WA
98815-1608
US

IV. Provider business mailing address

118 RUSTY SPUR LN
CASHMERE WA
98815-4505
US

V. Phone/Fax

Practice location:
  • Phone: 509-778-5240
  • Fax:
Mailing address:
  • Phone: 509-860-6725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61686017
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: