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General NPI Number Information
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NPI Number | 1669185203
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Entity Type | Organization
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Legal Business Name | SMITHS CLINICAL COUNSELING PLLC
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Dates
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Enumeration Date | 12/28/2022
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 4030 WAKE FOREST RD STE 349
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City | RALEIGH
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State | NC
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Zip | 27609-0010
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Country | US
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Telephone | 252-676-3822
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 WAKE FOREST RD STE 349
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City | RALEIGH
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State | NC
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Zip | 27609-0010
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Country | US
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Telephone | 252-676-3822
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | CHESTER SMITH
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Credential | LCMHC
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Telephone | 252-676-3822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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