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General NPI Number Information
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NPI Number | 1073678876
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Entity Type | Individual
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Provider Name | LINDA GEORGETTE SMITH LCSW, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 09/06/2013
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Provider Practice Location Address
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Address Line | 123 E GAY ST
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City | WARRENSBURG
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State | MO
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Zip | 64093-1809
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Country | US
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Telephone | 660-747-9242
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Fax |
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Provider Business Mailing Address
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Address Line | 2713 SHELBY ST
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City | HIGGINSVILLE
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State | MO
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Zip | 64037-2079
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Country | US
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Telephone | 660-584-3043
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Fax | 660-584-7846
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 000272
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000272
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 000272
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 004173
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License Number State | MO
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