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General NPI Number Information
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NPI Number | 1477323756
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Entity Type | Individual
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Provider Name | AMY TAYLOR-SMITH LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 121 ROLLING HILL RD STE 110B
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City | MOORESVILLE
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State | NC
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Zip | 28117-8856
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Country | US
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Telephone | 704-360-2464
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Fax | 980-701-0073
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Provider Business Mailing Address
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Address Line | 121 ROLLING HILL RD STE 110B
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City | MOORESVILLE
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State | NC
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Zip | 28117-8856
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Country | US
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Telephone | 704-360-2464
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Fax | 980-701-0073
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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 | A19523
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License Number State | NC
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