Provider Demographics
NPI:1366082059
Name:SMITH, RAMICHA T (LPCC)
Entity type:Individual
Prefix:
First Name:RAMICHA
Middle Name:T
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 SOUTHERN PKWY STE 2C
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-1442
Mailing Address - Country:US
Mailing Address - Phone:502-690-2010
Mailing Address - Fax:
Practice Address - Street 1:4602 SOUTHERN PKWY STE 2C
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1442
Practice Address - Country:US
Practice Address - Phone:502-690-2010
Practice Address - Fax:855-894-7439
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY260993101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY260993OtherLPCC