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NPI Code Detail

MEDICARE: KIMBERLY NICOLE SMITH

MEDICARE: KIMBERLY NICOLE SMITH
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1033614896
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY NICOLE SMITH
Provider Business Mailing Address
First Line : 6145 ADAM DR
Second Line :
City : MARRERO
State : LA
Zip : 70072-3505
Country : US
Telephone Number : 504-322-6496
Fax Number :
Provider Business Practice Location Address
First Line : 6145 ADAM DR
Second Line :
City : MARRERO
State : LA
Zip : 70072-3505
Country : US
Telephone Number : 504-322-6496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2018
Last Update Date : 09/18/2025

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Directions to “ KIMBERLY NICOLE SMITH ” Practice Location

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