Provider Demographics
NPI:1467200865
Name:SMEARMAN, LISA MARIE
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:MARIE
Last Name:SMEARMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5355 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1805
Mailing Address - Country:US
Mailing Address - Phone:562-379-4995
Mailing Address - Fax:
Practice Address - Street 1:5355 E CARSON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1805
Practice Address - Country:US
Practice Address - Phone:562-379-4995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARH0012101223101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)