Larry Smith

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2413A Issued in NC

Practice address

164 Waccamaw Medical Park Dr
Conway, SC 29526-8903

Phone

(843) 347-4888

Fax

(843) 347-3959

NPI assigned

Dec 6, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235474909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268903",
            "telephone_number": "843-347-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268903",
            "telephone_number": "843-347-4888",
            "fax_number": "843-347-3959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2031 Mlk Jr Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274063342",
            "country_code": "US",
            "telephone_number": "336-271-5817",
            "fax_number": "336-760-4406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LARRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2413A",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2413A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Smith
• Eric Levern Smith Sr., MENTAL HEALTH COUNS
• Justin Smith, CRNP
• Karen Jeanette Smith, CRNP
• Karen P Smith, RN
• Maritta Janice Smith
• Mary Elizabeth Smith
• Natrenah Smith
• Rebecca Smith
• Tapanga N Smith, PT, DPT

• Addiction (Substance Use Disorder) Counselor in Conway, SC
• Providers in Conway, SC by specialty
• Addiction (Substance Use Disorder) Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.