Provider Demographics
NPI:1609221001
Name:SMITH, ELINOR LEE (LPC,CACLL)
Entity Type:Individual
Prefix:MS
First Name:ELINOR
Middle Name:LEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC,CACLL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 SAVANNAH HWY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407
Mailing Address - Country:US
Mailing Address - Phone:843-607-5845
Mailing Address - Fax:866-261-6743
Practice Address - Street 1:571 SAVANNAH HWY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407
Practice Address - Country:US
Practice Address - Phone:843-607-5845
Practice Address - Fax:866-261-6743
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3249101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)