Individual
BETTY JO SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC CACIII
Contact information
Practice address
325 SECOND ST, MONUMENT, CO 80132-7935
(719) 487-1102
(719) 488-8103
Mailing address
PO BOX 1148, MONUMENT, CO 80132-1148
(719) 487-1102
(719) 488-8103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3528
CO
101YP2500X
Professional Counselor
Primary
2589
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082770
—
CO
Enumeration date
04/05/2006
Last updated
12/28/2011
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