MEDICARE: MRS. RACHEL LEE SMITH MA, MED

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	907	WV
2	101YS0200X	School Counselor	E6C141300070	WV

General Provider Information

NPI Number	:	1386456077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL LEE SMITH MA, MED

Provider Business Mailing Address
First Line	:	8257 MOUNT CLARE RD
Second Line	:
City	:	MOUNT CLARE
State	:	WV
Zip	:	26408-0349
Country	:	US
Telephone Number	:	304-365-0859
Fax Number	:

Provider Business Practice Location Address
First Line	:	613 W PIKE ST
Second Line	:
City	:	CLARKSBURG
State	:	WV
Zip	:	26301-2626
Country	:	US
Telephone Number	:	304-622-5323
Fax Number	:	304-622-5324

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

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	04/15/2026

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