Basic Information
| Provider Information | |||||||||
| NPI: | 1790194926 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | PAUL | ||||||||
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| Credential: | LPCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 W US HIGHWAY 64 | ||||||||
| Address2: | |||||||||
| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289068115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8288370071 | ||||||||
| FaxNumber: | 8288375309 | ||||||||
| Practice Location | |||||||||
| Address1: | 1482 RUSS AVE | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287864143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284521395 | ||||||||
| FaxNumber: | 8284521396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2014 | ||||||||
| LastUpdateDate: | 08/14/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | A11011 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.