Provider Demographics
NPI:1811190549
Name:JAN ANDERSON SMITH LPC, INC.
Entity Type:Organization
Organization Name:JAN ANDERSON SMITH LPC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-LICENSED COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LPC
Authorized Official - Phone:706-494-8778
Mailing Address - Street 1:1661 13TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3840
Mailing Address - Country:US
Mailing Address - Phone:706-494-8778
Mailing Address - Fax:706-324-2088
Practice Address - Street 1:1661 13TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3840
Practice Address - Country:US
Practice Address - Phone:706-494-8778
Practice Address - Fax:706-324-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC001327251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health