Provider Demographics
NPI:1720504350
Name:SMITH, SYLVIA ELAINE (LPC)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:ELAINE
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 1:3319 GLENROSE TRL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-5781
Mailing Address - Country:US
Mailing Address - Phone:404-444-8956
Mailing Address - Fax:
Practice Address - Street 1:3319 GLENROSE TRL
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-5781
Practice Address - Country:US
Practice Address - Phone:404-444-8956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional