Provider Demographics
NPI:1831386978
Name:SMALLEY-MCMAHAN, BARBARA LEA (MDIV)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:LEA
Last Name:SMALLEY-MCMAHAN
Suffix:
Gender:F
Credentials:MDIV
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:LEA
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MDIV
Mailing Address - Street 1:602 N BLOODWORTH ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1228
Mailing Address - Country:US
Mailing Address - Phone:919-754-3900
Mailing Address - Fax:919-754-3900
Practice Address - Street 1:602 N BLOODWORTH ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1228
Practice Address - Country:US
Practice Address - Phone:919-754-3900
Practice Address - Fax:919-754-3900
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2224101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional