MEDICARE: PAIGE FORRESTER SMITH LMFT, LAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	135	SC
2	106H00000X	Marriage & Family Therapist	4627	SC

General Provider Information

NPI Number	:	1578980389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE FORRESTER SMITH LMFT, LAC

Provider Business Mailing Address
First Line	:	250 DEWEY AVE
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29303-3009
Country	:	US
Telephone Number	:	864-585-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	904 WALNUT GROVE PAULINE RD
Second Line	:
City	:	PAULINE
State	:	SC
Zip	:	29374-2234
Country	:	US
Telephone Number	:	864-590-3116
Fax Number	:

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

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	09/03/2024

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