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NPI Code Detail

MEDICARE: MARYSUE CARLETTA SMELCER LPC

MEDICARE: MARYSUE CARLETTA SMELCER 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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor2986TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598720807
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYSUE CARLETTA SMELCER LPC
Provider Business Mailing Address
First Line : 200 TECH CENTER DR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-2747
Country : US
Telephone Number : 865-637-9711
Fax Number : 865-637-4362
Provider Business Practice Location Address
First Line : 600 ARTHUR ST
Second Line :
City : KNOXVILLE
State : TN
Zip : 37921-6405
Country : US
Telephone Number : 865-637-9711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 05/05/2022

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Directions to “ MARYSUE CARLETTA SMELCER LPC” Practice Location

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