Provider Demographics
NPI:1295417780
Name:SMITH, ALISON SKILLMAN (LPC)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:SKILLMAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4482 COMMERCE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7511
Mailing Address - Country:US
Mailing Address - Phone:678-995-5545
Mailing Address - Fax:
Practice Address - Street 1:4482 COMMERCE DR STE 101
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-7511
Practice Address - Country:US
Practice Address - Phone:678-995-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014311101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional