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Organization
SMITH COUNSELING CLINIC INC
Active
Organization
SMITH COUNSELING CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY W SMITH PHD (COUNSELOR)
(229) 524-8994
Entity
Organization
Contact information
Practice address
804 N WILEY AVE, DONALSONVILLE, GA 39845-1120
(229) 524-8994
(229) 524-1272
Mailing address
804 N WILEY AVE, DONALSONVILLE, GA 39845-1120
(229) 524-8994
(229) 524-1272
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC004048
LICENSE
GA
Enumeration date
07/24/2008
Last updated
07/24/2008
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