MEDICARE: DENISHA SMITH LPC

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	0701006757	VA

General Provider Information

NPI Number	:	1457800278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISHA SMITH LPC

Provider Business Mailing Address
First Line	:	2801 MCRAE RD STE 2C
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-3056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 MCRAE RD STE 2C
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-3056
Country	:	US
Telephone Number	:	804-878-5810
Fax Number	:

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

Provider Enumeration Date	:	09/22/2016
Last Update Date	:	01/10/2024

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