Provider Demographics
NPI:1710645502
Name:SMITH, MARY FRANCES (LCMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W 4TH ST STE 228
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-1545
Mailing Address - Country:US
Mailing Address - Phone:980-875-8761
Mailing Address - Fax:
Practice Address - Street 1:227 W 4TH ST STE 228
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-1545
Practice Address - Country:US
Practice Address - Phone:980-875-8761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health