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General NPI Number Information
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NPI Number | 1013037464
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Entity Type | Individual
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Provider Name | WALTER JAMES SMITH MA, LCPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 4 HARNISH LANE
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City | RED LODGE
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State | MT
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Zip | 59068-1992
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Country | US
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Telephone | 406-671-6289
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Fax | 406-446-2114
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Provider Business Mailing Address
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Address Line | PO BOX 1992
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City | RED LODGE
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State | MT
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Zip | 59068-1992
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Country | US
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Telephone | 406-672-6289
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Fax | 406-446-2114
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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 | LCPC 40
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License Number State | MT
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