Provider Demographics
NPI:1407360787
Name:SMITH, DOROTHY FIRTH (MA, LPC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:FIRTH
Last Name:SMITH
Suffix:
Gender:F
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 1:10700 MEDLOCK BRIDGE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8455
Mailing Address - Country:US
Mailing Address - Phone:404-383-8036
Mailing Address - Fax:404-745-8565
Practice Address - Street 1:10700 MEDLOCK BRIDGE RD STE 101
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-8455
Practice Address - Country:US
Practice Address - Phone:404-383-8036
Practice Address - Fax:404-745-8565
Is Sole Proprietor?:No
Enumeration Date:2017-11-26
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67577101YP2500X
GALPC010893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional