Provider Demographics
NPI:1588000699
Name:SMITH, TARA LYNNE (BA, CACP)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:LYNNE
Last Name:SMITH
Suffix:
Gender:
Credentials:BA, CACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3039
Mailing Address - Country:US
Mailing Address - Phone:864-898-5800
Mailing Address - Fax:864-898-5804
Practice Address - Street 1:208 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3039
Practice Address - Country:US
Practice Address - Phone:864-898-5800
Practice Address - Fax:864-898-5804
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)