MEDICARE: LISA K. SMITH LCPC, 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	LC13559	MD
2	101YP2500X	Professional Counselor	PC017828	PA

General Provider Information

NPI Number	:	1699309047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA K. SMITH LCPC, LPC

Provider Business Mailing Address
First Line	:	1707 ROSEMONT AVE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4135
Country	:	US
Telephone Number	:	301-241-7017
Fax Number	:

Provider Business Practice Location Address
First Line	:	1707 ROSEMONT AVE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4135
Country	:	US
Telephone Number	:	301-241-7017
Fax Number	:

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

Provider Enumeration Date	:	02/25/2020
Last Update Date	:	03/19/2026

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