Individual
STEPHANIE MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
4210 MESA GRANDE PL SE, ALBUQUERQUE, NM 87108-2709
(520) 288-1079
Mailing address
4210 MESA GRANDE PL SE, ALBUQUERQUE, NM 87108-2709
(520) 288-1079
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701013645
VA
101YP2500X
Professional Counselor
CTB-2022-0151
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93688245
—
NM
Enumeration date
09/25/2019
Last updated
01/01/2026
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