Provider Demographics
NPI:1265681852
Name:SMITH, DUANE (MA LPC)
Entity Type:Individual
Prefix:MR
First Name:DUANE
Middle Name:
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 1:3030 TOM SAVAGE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-8612
Mailing Address - Country:US
Mailing Address - Phone:704-804-6586
Mailing Address - Fax:
Practice Address - Street 1:3030 TOM SAVAGE DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-8612
Practice Address - Country:US
Practice Address - Phone:704-804-6586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional