Provider Demographics
NPI:1275976698
Name:RICHARDS-SMITH, DONALD (LCSW, LCAS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:RICHARDS-SMITH
Suffix:
Gender:M
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GOLD ST NE
Mailing Address - Street 2:POST OFFICE BOX 459
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4020
Mailing Address - Country:US
Mailing Address - Phone:252-265-8400
Mailing Address - Fax:252-265-5357
Practice Address - Street 1:100 GOLD ST NE
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4020
Practice Address - Country:US
Practice Address - Phone:252-265-8400
Practice Address - Fax:252-265-5357
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2670101YA0400X
NCC0085191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)