Provider Demographics
NPI:1235029562
Name:SMITH, RENEE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:NICOLE
Other - Last Name:SMITHHILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFTC
Mailing Address - Street 1:1350 S CANOE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7757
Mailing Address - Country:US
Mailing Address - Phone:719-439-4374
Mailing Address - Fax:
Practice Address - Street 1:5540 N ACADEMY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3682
Practice Address - Country:US
Practice Address - Phone:719-204-5112
Practice Address - Fax:719-982-2275
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAADDC0000594101YA0400X
CO14833106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)