MEDICARE: WAYNETTE K SMITH LPC-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	03273	AL

General Provider Information

NPI Number	:	1033459706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAYNETTE K SMITH LPC-S

Provider Business Mailing Address
First Line	:	2100 SOUTHBRIDGE PKWY STE 650
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-1317
Country	:	US
Telephone Number	:	205-572-0562
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 SOUTHBRIDGE PKWY STE 650
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-1317
Country	:	US
Telephone Number	:	205-572-0562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2013
Last Update Date	:	03/19/2024

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Directions to “ WAYNETTE K SMITH LPC-S” Practice Location

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