Provider Demographics
NPI:1255615480
Name:SMITH, RAYLAND L (LPC, BC-TMH)
Entity type:Individual
Prefix:
First Name:RAYLAND
Middle Name:L
Last Name:SMITH
Suffix:
Gender:M
Credentials:LPC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24600 COUNTY ROAD 21
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-9765
Mailing Address - Country:US
Mailing Address - Phone:719-469-2670
Mailing Address - Fax:
Practice Address - Street 1:24600 COUNTY ROAD 21
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-9765
Practice Address - Country:US
Practice Address - Phone:719-469-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0011961101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional