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NPI Code Detail

MEDICARE: CECILIA SMITH LCMHC

MEDICARE: CECILIA SMITH LCMHC
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
1101YP2500XProfessional CounselorA13741NC
2101YM0800XMental Health Counselor13741NC

General Provider Information

NPI Number : 1366942559
Entity Type Code : Individual
Provider Name (Legal Business Name) : CECILIA SMITH LCMHC
Provider Business Mailing Address
First Line : 200 E 2ND AVE
Second Line :
City : GASTONIA
State : NC
Zip : 28052-4358
Country : US
Telephone Number : 704-730-7003
Fax Number :
Provider Business Practice Location Address
First Line : 3050 RIVERWOOD PKWY STE B
Second Line :
City : GASTONIA
State : NC
Zip : 28056-6002
Country : US
Telephone Number : 704-874-9005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2018
Last Update Date : 04/17/2025

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Directions to “ CECILIA SMITH LCMHC” Practice Location

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