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Individual

MR. DIMAYQUOAYE A SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCAS, GCDF, ICAADC

Contact information

Practice address
501 N LAFAYETTE ST STE B, SHELBY, NC 28150-4477
(704) 284-9440
Mailing address
122 BROOKHILL RD, SHELBY, NC 28150-4602
(704) 284-9440

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
14447
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
20651
NC
101YM0800X
Mental Health Counselor
20651
NC

Other

Enumeration date
07/20/2018
Last updated
05/23/2019
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