Provider Demographics
NPI:1851714653
Name:SMITH, JAMES M (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:M
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:27 RIDGECREST TER
Mailing Address - Street 2:APT 14
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-5235
Mailing Address - Country:US
Mailing Address - Phone:617-460-3079
Mailing Address - Fax:
Practice Address - Street 1:5 HIGH ST STE 101
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3800
Practice Address - Country:US
Practice Address - Phone:781-338-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health