Provider Demographics
NPI:1386792380
Name:SMITH, CATHY ANNE (M COUN MFT)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:ANNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:M COUN MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 W DESERT INN RD
Mailing Address - Street 2:STE. 102-218
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4401
Mailing Address - Country:US
Mailing Address - Phone:702-938-8887
Mailing Address - Fax:702-938-4160
Practice Address - Street 1:7471 TECH CENTER CT.
Practice Address - Street 2:STE. 106
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:702-938-8887
Practice Address - Fax:702-838-4160
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0427101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health