Provider Demographics
NPI:1740268804
Name:SMITH, RAY WILLIAM (LMHC)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:WILLIAM
Last Name:SMITH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 N DIVISION ST
Mailing Address - Street 2:THE HOLLAND BUILDING, SUITE A
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1248
Mailing Address - Country:US
Mailing Address - Phone:509-466-6632
Mailing Address - Fax:509-466-0117
Practice Address - Street 1:9507 N DIVISION ST
Practice Address - Street 2:THE HOLLAND BUILDING, SUITE A
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1248
Practice Address - Country:US
Practice Address - Phone:509-466-6632
Practice Address - Fax:509-466-0117
Is Sole Proprietor?:No
Enumeration Date:2006-01-08
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004487101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health