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General NPI Number Information
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NPI Number | 1669950507
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Entity Type | Individual
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Provider Name | CHEYENNE SMITH LCSW, MSW
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Gender | Female
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Dates
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Enumeration Date | 08/02/2018
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 1791 S CAMPTON AVE UNIT 429
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City | ANAHEIM
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State | CA
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Zip | 92805-7440
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Country | US
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Telephone | 951-623-7352
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Fax |
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Provider Business Mailing Address
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Address Line | 1791 S CAMPTON AVE UNIT 429
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City | ANAHEIM
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State | CA
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Zip | 92805-7440
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Country | US
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Telephone | 951-623-7352
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 89382
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 112399
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License Number State | CA
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