Provider Demographics
NPI:1679130918
Name:SMITH, SARAH KAITLYN (ALC, NCC)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:KAITLYN
Last Name:SMITH
Suffix:
Gender:
Credentials:ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660037
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35266-0037
Mailing Address - Country:US
Mailing Address - Phone:205-356-9817
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 660037
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35266-0037
Practice Address - Country:US
Practice Address - Phone:205-356-9817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3295A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health