Provider Demographics
NPI:1023226925
Name:SMITH, CHRISTOPHER L (LCAC, LMHC, LMFT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCAC, LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-0685
Mailing Address - Country:US
Mailing Address - Phone:646-513-2866
Mailing Address - Fax:646-513-2860
Practice Address - Street 1:124 E 40TH ST
Practice Address - Street 2:SUITE 404
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1723
Practice Address - Country:US
Practice Address - Phone:212-655-9605
Practice Address - Fax:646-513-2860
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000653A101YA0400X
IN86000127A101YA0400X
NY002224101YM0800X
IN39000509A101YM0800X
103TP2701X, 174V00000X, 101YP1600X
NY000899106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No174V00000XOther Service ProvidersClinical Ethicist