Samantha Jane Smith, LPC
Counselor, Professional in Saint Louis, MO. Individual provider (NPI-1).
NPI number1124613005
StatusActive
Last updated in NPPESApr 14, 2023
Details
- NPI
- 1124613005
- Entity type
- Individual (NPI-1)
- Name
- Samantha Jane Smith
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 3, 2021
- Certification date
- Apr 14, 2023
- Last updated
- Apr 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Practice location
11166 Tesson Ferry Rd Ste 300Saint Louis, MO 63123-6966
Phone 314-802-2658 · Fax 314-842-2552
Mailing address
2650 Olive StSaint Louis, MO 63103-1489
Phone 314-371-6500
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