Provider Demographics
NPI:1154694545
Name:SMITH, LUCY ROLDAN (LPC, LCMFT)
Entity type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:ROLDAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 N MULBERRY DR STE 245
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-2259
Mailing Address - Country:US
Mailing Address - Phone:816-694-9275
Mailing Address - Fax:
Practice Address - Street 1:7940 PARALLEL PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2050
Practice Address - Country:US
Practice Address - Phone:816-694-9275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006012562101YP2500X
MO2005037146106H00000X
KS813106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist