Provider Demographics
NPI:1932823010
Name:SMITH, ALLISON MARIE (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5583 WINDY KNOLL PL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4878
Mailing Address - Country:US
Mailing Address - Phone:201-303-1377
Mailing Address - Fax:
Practice Address - Street 1:805 SPRING FOREST RD STE 800
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-9130
Practice Address - Country:US
Practice Address - Phone:919-418-1718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17905101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health