Provider Demographics
NPI:1417609520
Name:SMITH, GEORGIA LAVADA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:LAVADA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-4153
Mailing Address - Country:US
Mailing Address - Phone:828-222-0769
Mailing Address - Fax:828-544-1201
Practice Address - Street 1:802 FAIRVIEW RD STE 4000
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1170
Practice Address - Country:US
Practice Address - Phone:828-222-0769
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17279101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health