Provider Demographics
NPI:1275189557
Name:SMITH, ADRIENE DONIELLE (LMFT-A)
Entity Type:Individual
Prefix:MS
First Name:ADRIENE
Middle Name:DONIELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 E NC HIGHWAY 54 STE 300
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-3210
Mailing Address - Country:US
Mailing Address - Phone:919-474-6400
Mailing Address - Fax:919-474-6401
Practice Address - Street 1:1822 E NC HIGHWAY 54 STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-3210
Practice Address - Country:US
Practice Address - Phone:919-474-6400
Practice Address - Fax:919-474-6401
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12168A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist