Provider Demographics
NPI:1588209621
Name:SMITH, HANNAH MARIE TODD (MA, NCC, LPCA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE TODD
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, NCC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 SHADOWBROOK LN UNIT 206
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-3243
Mailing Address - Country:US
Mailing Address - Phone:615-260-8070
Mailing Address - Fax:
Practice Address - Street 1:141 SHADOWBROOK LN UNIT 206
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-3243
Practice Address - Country:US
Practice Address - Phone:615-260-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCOU.7264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health