Provider Demographics
NPI:1588910764
Name:SMITH, ERIN (LCMHC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-9775
Mailing Address - Country:US
Mailing Address - Phone:336-392-1681
Mailing Address - Fax:
Practice Address - Street 1:8325 US HWY 70 BUS W
Practice Address - Street 2:SUITE A2
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-772-1990
Practice Address - Fax:919-772-1978
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9512101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health