Provider Demographics
NPI:1720774516
Name:SMITH, DAWN N (LGPC)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:N
Last Name:SMITH
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 AUTUMN SAGE LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6707
Mailing Address - Country:US
Mailing Address - Phone:240-855-8330
Mailing Address - Fax:
Practice Address - Street 1:6710 OXON HILL RD STE 210
Practice Address - Street 2:
Practice Address - City:FOREST HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20745-1124
Practice Address - Country:US
Practice Address - Phone:833-833-2685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health