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Individual

SUSAN KELLAS SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
QMHP

Contact information

Practice address
500 PEGASUS COURT BUSINESS CENTER STE 500, WINCHESTER, VA 22602
(800) 805-6989
(864) 558-8511
Mailing address
200 E BROAD ST STE 300, GREENVILLE, SC 29601-2891
(800) 805-6989
(864) 558-8511

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
VA
101YM0800X
Mental Health Counselor
0733004211
VA

Other

Enumeration date
07/27/2022
Last updated
07/27/2022
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