Provider Demographics
NPI:1144438300
Name:SMITH, DAVID M (LPC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2750 OLD ALABAMA RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8593
Mailing Address - Country:US
Mailing Address - Phone:678-336-3260
Mailing Address - Fax:678-336-3282
Practice Address - Street 1:2750 OLD ALABAMA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8593
Practice Address - Country:US
Practice Address - Phone:678-336-3260
Practice Address - Fax:678-336-3282
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3337101YP2500X
NC2436101YP2500X
SC2384101YP2500X
NC558106H00000X
SC2513106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist