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General NPI Number Information
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NPI Number | 1710341656
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Entity Type | Individual
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Provider Name | CATHY MARIE SMITH
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Gender | Female
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 3991 HIGHWAY 78 W STE 203
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City | SNELLVILLE
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State | GA
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Zip | 30039-3929
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Country | US
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Telephone | 770-978-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 MAPLE CREEK DR
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City | LOGANVILLE
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State | GA
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Zip | 30052-7113
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Country | US
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Telephone | 770-891-3165
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC011089
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License Number State | GA
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