Provider Demographics
NPI:1174068878
Name:DEBORAH L SMITH, ED.M./LMHC
Entity type:Organization
Organization Name:DEBORAH L SMITH, ED.M./LMHC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:509-222-1348
Mailing Address - Street 1:6917 W GRANDRIDGE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7737
Mailing Address - Country:US
Mailing Address - Phone:509-222-1348
Mailing Address - Fax:509-737-9010
Practice Address - Street 1:6917 W GRANDRIDGE BLVD STE D
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7737
Practice Address - Country:US
Practice Address - Phone:509-222-1348
Practice Address - Fax:509-737-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty