Individual
MR. JAMES ANTONIO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSC, CADC II, ICADC
Contact information
Practice address
669 CASTLEBOTTOM DR, LAWRENCEVILLE, GA 30045-2796
(518) 955-8868
Mailing address
669 CASTLEBOTTOM DR, LAWRENCEVILLE, GA 30045-2796
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1140
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1140
THE ALCOHOL AND DRUG ABUSE CERTIFICATION BOARD OF GEORGIA, INC.
GA
01
—
806645
INTERNATIONAL CERTIFICATION & RECIPROCITY CONSORTIUM
PA
Enumeration date
12/19/2018
Last updated
12/19/2018
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