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NPI Code Detail

MEDICARE: TARA LYNNE SMITH B.A., CACP

MEDICARE: TARA LYNNE SMITH B.A., CACP
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1588000699
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA LYNNE SMITH B.A., CACP
Provider Business Mailing Address
First Line : 208 E 1ST AVE
Second Line :
City : EASLEY
State : SC
Zip : 29640-3039
Country : US
Telephone Number : 864-898-5800
Fax Number : 864-898-5804
Provider Business Practice Location Address
First Line : 208 E 1ST AVE
Second Line :
City : EASLEY
State : SC
Zip : 29640-3039
Country : US
Telephone Number : 864-898-5800
Fax Number : 864-898-5804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2013
Last Update Date : 02/26/2025

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