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General NPI Number Information
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NPI Number | 1699853879
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Entity Type | Individual
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Provider Name | YVONNE DENISE SMITH LCAS, CCS
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 10/17/2012
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Provider Practice Location Address
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Address Line | 226 BRADFORD AVENUE
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City | FAYETTEVILLE
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State | NC
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Zip | 28301
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Country | US
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Telephone | 910-829-9017
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Fax | 910-485-4752
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Provider Business Mailing Address
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Address Line | 226 BRADFORD AVENUE
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City | FAYETTEVILLE
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State | NC
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Zip | 28301
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Country | US
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Telephone | 910-829-9017
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Fax | 910-485-4752
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 764
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-746;CCS-520
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License Number State | NC
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