Individual
CAROL COUNCIL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
50 STONERIDGE RD., DURHAM, NC 27705-5578
(919) 489-8607
Mailing address
50 STONERIDGE RD., DURHAM, NC 27705-5578
(919) 489-8607
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1581
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11111
NO MEDICAID NUMBER
NC
Enumeration date
07/29/2009
Last updated
07/29/2009
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