Provider Demographics
NPI:1598417842
Name:SMITH, COLTER ROBERT (MS, LMHCA)
Entity type:Individual
Prefix:MR
First Name:COLTER
Middle Name:ROBERT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MS, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 E DIVISION ST APT D
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4655
Mailing Address - Country:US
Mailing Address - Phone:360-610-3229
Mailing Address - Fax:
Practice Address - Street 1:1005 N PINES RD STE 500
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4958
Practice Address - Country:US
Practice Address - Phone:509-980-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WAMC61429421101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor