Provider Demographics
NPI:1154165967
Name:SMITH, LAKESHA
Entity type:Individual
Prefix:MRS
First Name:LAKESHA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 BALTIMORE AVE STE 402G
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4073
Mailing Address - Country:US
Mailing Address - Phone:443-648-0744
Mailing Address - Fax:
Practice Address - Street 1:606 BALTIMORE AVE STE 402G
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4073
Practice Address - Country:US
Practice Address - Phone:443-648-0744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health