MEDICARE: MRS. DAWN N SMITH LGPC

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	101YM0800X	Mental Health Counselor	LGP12951	MD

General Provider Information

NPI Number	:	1720774516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN N SMITH LGPC

Provider Business Mailing Address
First Line	:	1513 AUTUMN SAGE LN
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-6707
Country	:	US
Telephone Number	:	240-855-8330
Fax Number	:

Provider Business Practice Location Address
First Line	:	6710 OXON HILL RD STE 210
Second Line	:
City	:	FOREST HEIGHTS
State	:	MD
Zip	:	20745-1124
Country	:	US
Telephone Number	:	833-833-2685
Fax Number	:

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

Provider Enumeration Date	:	04/13/2023
Last Update Date	:	04/13/2023

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