Individual
DR. JERRY HOWARD SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAC, LPC, LCAS, CCS
Contact information
Practice address
818 S MAIN ST, BLADENBORO, NC 28320-5970
(910) 863-4000
Mailing address
315 DOVE FIELD CT SE, LELAND, NC 28451-9619
(910) 880-9810
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5146
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103024
—
NC
Enumeration date
10/10/2006
Last updated
06/08/2012
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