Provider Demographics
NPI:1689402984
Name:SMITH, JAMES TIMOTHY (LPC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TIMOTHY
Last Name:SMITH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5022 ROCKING R DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-1130
Mailing Address - Country:US
Mailing Address - Phone:720-975-7268
Mailing Address - Fax:
Practice Address - Street 1:5022 ROCKING R DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80915-1130
Practice Address - Country:US
Practice Address - Phone:720-975-7268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional