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Individual

MR. GENE PRESTON SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCAS

Contact information

Practice address
1045 MAIN ST, STE.3, DANVILLE, VA 24541-1800
(434) 822-6600
(434) 822-6600
Mailing address
1045 MAIN ST, STE.3, DANVILLE, VA 24541-1800
(434) 822-6600
(434) 822-6600

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
560
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
560
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
561827601
TAX ID
NC
Enumeration date
12/21/2012
Last updated
12/21/2012
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