Individual
MR. GORDON HILTON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
4701 FAYETTEVILLE RD, LUMBERTON, NC 28358-2697
(910) 739-9755
(910) 739-9788
Mailing address
4701 FAYETTEVILLE RD, LUMBERTON, NC 28358-2697
(910) 739-9755
(910) 739-9788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
407
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
407
LCAS NUMBER
NC
05
—
6111783
—
NC
Enumeration date
09/20/2006
Last updated
02/16/2011
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