Individual
KELLY ELIZABETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC
Contact information
Practice address
216 GILMER STREET, LEBANON, VA 24266
(276) 889-3063
Mailing address
PO BOX 810, CEDAR BLUFF, VA 24609-0810
(276) 964-6702
(276) 964-0292
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103119
VA
1041C0700X
Clinical Social Worker
Primary
0904010148
VA
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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