Provider Demographics
NPI:1518297811
Name:SMITH, GENEVIEVE LOUANN (MA LPC)
Entity type:Individual
Prefix:MS
First Name:GENEVIEVE
Middle Name:LOUANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8574 DEPEW ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-1322
Mailing Address - Country:US
Mailing Address - Phone:720-249-7259
Mailing Address - Fax:
Practice Address - Street 1:4800 WADSWORTH BLVD
Practice Address - Street 2:STE 135
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3317
Practice Address - Country:US
Practice Address - Phone:720-443-3048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC5501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional