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General NPI Number Information
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NPI Number | 1548664154
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Entity Type | Individual
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Provider Name | ROSLYN SMITH LPC
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Gender | Female
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Dates
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Enumeration Date | 10/10/2014
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 350 W WOODROW WILSON AVE SUITE 3572
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City | JACKSON
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State | MS
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Zip | 39213-7681
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Country | US
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Telephone | 601-966-0167
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Fax |
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Provider Business Mailing Address
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Address Line | 350 W WOODROW WILSON AVE STE 3572
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City | JACKSON
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State | MS
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Zip | 39213-7682
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Country | US
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Telephone | 769-251-5303
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Fax | 769-251-5681
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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 | 1251
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License Number State | MS
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