Provider Demographics
NPI:1356645980
Name:SMITH, LORI A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72089-0298
Mailing Address - Country:US
Mailing Address - Phone:501-847-2229
Mailing Address - Fax:501-847-8608
Practice Address - Street 1:15524 CHENAL PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2018
Practice Address - Country:US
Practice Address - Phone:501-847-2229
Practice Address - Fax:501-847-8608
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2013-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1204050101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional