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General NPI Number Information
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NPI Number | 1730952086
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Entity Type | Individual
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Provider Name | JEREMY SMITH LPC
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Gender | Male
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1200 S MAIN ST
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City | SEARCY
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State | AR
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Zip | 72143-7321
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Country | US
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Telephone | 501-278-3155
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 HAWKINS DR
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City | SEARCY
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State | AR
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Zip | 72143-4802
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Country | US
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Telephone | 501-278-2800
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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 | A2308014
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License Number State | AR
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