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General NPI Number Information
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NPI Number | 1346473188
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Entity Type | Individual
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Provider Name | NECA C SMITH LPC
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Gender | Female
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 3300 BUCKEYE RD SUITE 677
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City | ATLANTA
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State | GA
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Zip | 30341-4229
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Country | US
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Telephone | 404-537-1821
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Fax | 770-593-1821
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Provider Business Mailing Address
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Address Line | PO BOX 1423
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City | REDAN
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State | GA
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Zip | 30074-1423
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Country | US
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Telephone | 404-537-1821
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Fax | 770-593-9110
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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 | 004936
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License Number State | GA
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