Provider Demographics
NPI:1548294994
Name:JAMES-SMITH, MARY LYNN (LPA, LPCA)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LYNN
Last Name:JAMES-SMITH
Suffix:
Gender:F
Credentials:LPA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:201 GOVERNMENT AVE SW STE 305
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-2954
Mailing Address - Country:US
Mailing Address - Phone:828-267-1740
Mailing Address - Fax:828-267-1746
Practice Address - Street 1:201 GOVERNMENT AVE SW STE 305
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2954
Practice Address - Country:US
Practice Address - Phone:828-267-1740
Practice Address - Fax:828-267-1746
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1266101YP2500X, 103T00000X
NCA11253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist