Individual
BRENDA MCGILLIVRAY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC LMFT
Contact information
Practice address
250 OLD MILL LN, BROADWAY, VA 22815-2754
(540) 901-9000
(540) 901-9000
Mailing address
250 OLD MILL LN, BROADWAY, VA 22815-2754
(540) 901-9000
(540) 901-9000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002606
VA
106H00000X
Marriage & Family Therapist
0717000424
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005408806
—
VA
Enumeration date
04/12/2006
Last updated
09/09/2022
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