Provider Demographics
NPI:1992519755
Name:SMITH, MARIA AUGUSTA (LPC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:AUGUSTA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11106 SPRING MEADOW BLVD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2516
Mailing Address - Country:US
Mailing Address - Phone:910-539-2922
Mailing Address - Fax:
Practice Address - Street 1:4500 PLANK RD STE 1008
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-0133
Practice Address - Country:US
Practice Address - Phone:540-701-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty