Provider Demographics
NPI:1417492695
Name:SMITH, ERIK JOHN (LCMHC)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:JOHN
Last Name:SMITH
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 COTTON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3226
Mailing Address - Country:US
Mailing Address - Phone:704-473-5820
Mailing Address - Fax:
Practice Address - Street 1:117 N POPLAR ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3315
Practice Address - Country:US
Practice Address - Phone:704-754-4726
Practice Address - Fax:704-754-4726
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health