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General NPI Number Information
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NPI Number | 1386456077
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Entity Type | Individual
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Provider Name | RACHEL LEE SMITH MA, MED
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Gender | Female
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 243 W MAIN ST
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City | BRIDGEPORT
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State | WV
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Zip | 26330-1767
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Country | US
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Telephone | 304-842-8852
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Fax |
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Provider Business Mailing Address
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Address Line | 8257 MOUNT CLARE RD
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City | MOUNT CLARE
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State | WV
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Zip | 26408-0349
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Country | US
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Telephone | 304-365-0859
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | E6C141300070
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 907
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License Number State | WV
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