Provider Demographics
NPI:1083085658
Name:SMITH, CAROL TAYLOR (LPC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:TAYLOR
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:TAYLOR
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHP
Mailing Address - Street 1:10100 CHEVY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-2309
Mailing Address - Country:US
Mailing Address - Phone:504-359-9270
Mailing Address - Fax:504-246-6598
Practice Address - Street 1:2740 IBERVILLE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5516
Practice Address - Country:US
Practice Address - Phone:504-821-8184
Practice Address - Fax:504-821-8185
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional