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General NPI Number Information
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NPI Number | 1225450448
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Entity Type | Individual
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Provider Name | TERESA SMOAK MS, LPC, MAC
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Gender | Female
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 471 UNIVERSITY PKWY
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City | AIKEN
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State | SC
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Zip | 29801-6399
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Country | US
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Telephone | 803-641-3609
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Fax |
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Provider Business Mailing Address
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Address Line | 471 UNIVERSITY PARKWAY MAILBOX 15
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City | AIKEN
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State | SC
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Zip | 29801-6389
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Country | US
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Telephone | 803-641-3609
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC009247
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License Number State | GA
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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 | LPC-23581
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6327
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License Number State | SC
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