Provider Demographics
NPI:1700862752
Name:SMITH, LINDA DIANNE (LPC, CEAP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:DIANNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 DEER PATH
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-5093
Mailing Address - Country:US
Mailing Address - Phone:919-967-8543
Mailing Address - Fax:
Practice Address - Street 1:291 DEER PATH
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-5093
Practice Address - Country:US
Practice Address - Phone:919-967-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC010600101Y00000X
NC545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor