Provider Demographics
NPI:1265011399
Name:SMITH, CHARNAE ARIELLE (MS, ALC)
Entity Type:Individual
Prefix:MS
First Name:CHARNAE
Middle Name:ARIELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, ALC
Other - Prefix:MS
Other - First Name:CHARNAE
Other - Middle Name:ARIELLE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2400 PRESIDENTS DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-1617
Mailing Address - Country:US
Mailing Address - Phone:205-675-6592
Mailing Address - Fax:
Practice Address - Street 1:2400 PRESIDENTS DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-1617
Practice Address - Country:US
Practice Address - Phone:205-675-6592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3542A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor