Provider Demographics
NPI:1659743961
Name:SMITH, MARTY ELIZABETH (LCPC, LAC)
Entity Type:Individual
Prefix:MS
First Name:MARTY
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCPC, LAC
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMHC, LMHC,LCPC, LAC
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59103-0327
Mailing Address - Country:US
Mailing Address - Phone:406-414-9140
Mailing Address - Fax:406-318-0155
Practice Address - Street 1:1629 AVENUE D STE A9
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3042
Practice Address - Country:US
Practice Address - Phone:406-414-9140
Practice Address - Fax:406-318-0155
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-55101YA0400X
MTBBH-LCPC-LIC-37454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)