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General NPI Number Information
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NPI Number | 1013033406
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Entity Type | Individual
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Provider Name | AMBER MICHELLE SMITH MS, LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 802 N 8TH ST
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City | VANDALIA
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State | IL
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Zip | 62471-1756
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Country | US
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Telephone | 618-293-1731
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 E 1000TH AVE
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City | ALTAMONT
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State | IL
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Zip | 62411-3414
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Country | US
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Telephone | 618-483-5749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | IL
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