Provider Demographics
NPI:1366570111
Name:SMITH, DAVID A (LCAS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2307 NORWOOD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1601
Mailing Address - Country:US
Mailing Address - Phone:919-735-8887
Mailing Address - Fax:919-735-7207
Practice Address - Street 1:2307 NORWOOD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1601
Practice Address - Country:US
Practice Address - Phone:919-735-8887
Practice Address - Fax:919-735-7207
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)