Provider Demographics
NPI:1073796199
Name:SMITH, CHRISTOPHER BLAKE (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BLAKE
Last Name:SMITH
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 WHITE PINE DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2224
Mailing Address - Country:US
Mailing Address - Phone:828-712-4689
Mailing Address - Fax:
Practice Address - Street 1:290 WHITE PINE DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2224
Practice Address - Country:US
Practice Address - Phone:828-712-4689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5602101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional