Provider Demographics
NPI:1225790850
Name:KATHRYN SMITH COUNSELING, LLC
Entity Type:Organization
Organization Name:KATHRYN SMITH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC NCC
Authorized Official - Phone:267-670-1806
Mailing Address - Street 1:223 PINNER LN APT 12
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-7526
Mailing Address - Country:US
Mailing Address - Phone:541-919-5156
Mailing Address - Fax:541-225-4878
Practice Address - Street 1:223 PINNER LN APT 12
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7526
Practice Address - Country:US
Practice Address - Phone:541-919-5156
Practice Address - Fax:541-225-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty