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Individual

JENNIFER BROADWAY SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
264 GREENSBORO STREET EXT, LEXINGTON, NC 27295-1969
(336) 236-7347
Mailing address
264 GREENSBORO STREET EXT, LEXINGTON, NC 27295-1969
(336) 236-7347

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A10089
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101YMO800X
MENTAL HEALTH
NC
Enumeration date
06/13/2013
Last updated
07/12/2017
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