Provider Demographics
NPI:1811168446
Name:SMITH, ALVIS WARREN (LPC, NCC)
Entity type:Individual
Prefix:
First Name:ALVIS
Middle Name:WARREN
Last Name:SMITH
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 MCALLISTER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-4825
Mailing Address - Country:US
Mailing Address - Phone:910-484-7434
Mailing Address - Fax:
Practice Address - Street 1:306 MCALLISTER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-4825
Practice Address - Country:US
Practice Address - Phone:910-484-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC993101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health