Estorious Eivadne' Smith, LPC
Individual provider Active NPI Professional Counselor · Auburn, GA
NPI 1831714732 · NPPES record last updated Jun 16, 2020
Key facts
- NPI
- 1831714732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC011134 (GA)
- Practice address
- 19 College St, #492
Auburn, GA 30011-4304 - Phone
- (478) 538-1470
- NPI assigned
- Jun 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC011134 | GA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC011134 | GA | Yes |
Addresses
Primary practice location
19 College St, #492
Auburn, GA 30011-4304
Mailing address
19 College St, #492
Auburn, GA 30011-4304
Phone (478) 538-1470
Other providers in Auburn, GA
- Jayoung Ryu
- Richard Mark Schlossberg
- Ruth M Silva
- Allen G Smith
- Angelique N Smith
- Becky Mai Sotillo
- Stone Health Services, LLC
- Johana Stowers
- Janine Swanagan
- Nicole Elizabeth Taylor
All providers in Auburn, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.