Provider Demographics
NPI:1073062261
Name:SMITH, NAOMI (LMHC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 RIDGE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2497
Mailing Address - Country:US
Mailing Address - Phone:585-484-7172
Mailing Address - Fax:866-898-3215
Practice Address - Street 1:807 RIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2497
Practice Address - Country:US
Practice Address - Phone:585-484-7172
Practice Address - Fax:866-898-3215
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006545-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health