Provider Demographics
NPI:1376041020
Name:SMITH, RACHAEL GIACCONE (LCAS, LCMHC)
Entity type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:GIACCONE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCAS, LCMHC
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:GIACCONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:779 ASHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2005
Mailing Address - Country:US
Mailing Address - Phone:910-273-9498
Mailing Address - Fax:
Practice Address - Street 1:779 ASHFIELD DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-2005
Practice Address - Country:US
Practice Address - Phone:910-273-9498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-29
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15203101YM0800X
NCLCAS-22722101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health