Provider Demographics
NPI:1548976582
Name:SMITH, CODIE LANI (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:CODIE
Middle Name:LANI
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 23RD ST S STE 280
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2463
Mailing Address - Country:US
Mailing Address - Phone:205-586-4405
Mailing Address - Fax:
Practice Address - Street 1:100 CENTERVIEW DR
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-3747
Practice Address - Country:US
Practice Address - Phone:205-318-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health