Individual
LAKELL SMALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 NNPTC CIR, GOOSE CREEK, SC 29445-6314
(843) 794-6456
Mailing address
200 CRAIG ST, EUTAWVILLE, SC 29048-9582
(843) 695-7234
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
02/02/2016
Last updated
05/10/2023
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