Provider Demographics
NPI:1629283213
Name:SMITH, JAMES ANTHONY (LCMFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANTHONY
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 E MAINSGATE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1062
Mailing Address - Country:US
Mailing Address - Phone:316-841-1986
Mailing Address - Fax:316-260-7045
Practice Address - Street 1:6525 E MAINSGATE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1062
Practice Address - Country:US
Practice Address - Phone:316-841-1986
Practice Address - Fax:316-260-7045
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2022-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS764106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist