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NPI Code Detail

MEDICARE: NATHANIEL SMITH

MEDICARE: NATHANIEL SMITH
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
1101YP2500XProfessional CounselorA22810NC
2101YM0800XMental Health CounselorA22810NC
3101Y00000XCounselorA22810NC

General Provider Information

NPI Number : 1770306086
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANIEL SMITH
Provider Business Mailing Address
First Line : 3825 MARKET ST STE 4
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-1426
Country : US
Telephone Number : 910-777-5575
Fax Number : 910-777-5273
Provider Business Practice Location Address
First Line : 720 SAINT JAMES DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-2937
Country : US
Telephone Number : 910-660-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2024
Last Update Date : 06/16/2026

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Directions to “ NATHANIEL SMITH ” Practice Location

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