Provider Demographics
NPI:1104192079
Name:SMITH, KARMEN (LMHC, CRC)
Entity Type:Individual
Prefix:
First Name:KARMEN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3491 GANDY BLVD N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-2658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3491 GANDY BLVD N
Practice Address - Street 2:SUITE 201
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-2658
Practice Address - Country:US
Practice Address - Phone:727-547-0607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 9780101YM0800X
FLMHC16931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health