Individual
PHILLIP SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1203 IDAHO ST, LEWISTON, ID 83501-1940
(509) 444-8888
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6366
ID
101YM0800X
Mental Health Counselor
60022726
WA
101YM0800X
Mental Health Counselor
Primary
LCPC-9211
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60022726
STATE LICENSE
WA
Enumeration date
01/23/2009
Last updated
04/30/2025
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