Provider Demographics
NPI:1205171048
Name:ORLANDO SMITH, NICOLE (LMHC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ORLANDO SMITH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BROADWAY STE 17&18
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-1099
Mailing Address - Country:US
Mailing Address - Phone:781-233-1095
Mailing Address - Fax:
Practice Address - Street 1:184 BROADWAY STE 302
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-1099
Practice Address - Country:US
Practice Address - Phone:781-233-1095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12794101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health