Individual
MS. KIM R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, LPC
Contact information
Practice address
210 N HIGHWAY 27 STE 4, CLERMONT, FL 34711-2411
(352) 708-6283
Mailing address
908 LAKE ELSIE DR, TAVARES, FL 32778-4978
(352) 409-6540
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH8094
FL
101YP2500X
Professional Counselor
Primary
7880
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766501600
—
FL
01
—
Z090M
BLUE CROSS BLUE SHIELD #
FL
Enumeration date
04/14/2006
Last updated
07/08/2024
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