Provider Demographics
NPI:1790009850
Name:SMITH, LINDSAY BETH (MHPP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:BETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 COUNTY ROAD 120
Mailing Address - Street 2:
Mailing Address - City:BONO
Mailing Address - State:AR
Mailing Address - Zip Code:72416-8603
Mailing Address - Country:US
Mailing Address - Phone:870-378-1324
Mailing Address - Fax:
Practice Address - Street 1:279 COUNTY ROAD 120
Practice Address - Street 2:
Practice Address - City:BONO
Practice Address - State:AR
Practice Address - Zip Code:72416-8603
Practice Address - Country:US
Practice Address - Phone:870-378-1324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR923115344171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator