Provider Demographics
NPI:1477370039
Name:SMITH, CAITLIN ALEXIA (MS, LPC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ALEXIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2147 HOFFMEYER RD STE A
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4015
Mailing Address - Country:US
Mailing Address - Phone:843-960-2050
Mailing Address - Fax:843-799-0091
Practice Address - Street 1:2147 HOFFMEYER RD STE A
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4015
Practice Address - Country:US
Practice Address - Phone:843-960-2050
Practice Address - Fax:843-799-0091
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10293101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional