Provider Demographics
NPI:1205166857
Name:SMITH, KATHYRN H (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:KATHYRN
Middle Name:H
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 1:425 S BABOOSIC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-2926
Mailing Address - Country:US
Mailing Address - Phone:603-424-6476
Mailing Address - Fax:
Practice Address - Street 1:65 TECHNOLOGY WAY
Practice Address - Street 2:SUITE 3W7
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3245
Practice Address - Country:US
Practice Address - Phone:603-886-5565
Practice Address - Fax:603-886-8642
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH789101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor