Individual
CARLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
28 STATE ST STE 5, GORHAM, ME 04038-1147
(207) 222-0299
Mailing address
28 STATE ST STE 5, GORHAM, ME 04038-1147
(207) 222-0299
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2021
Last updated
02/02/2026
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