Provider Demographics
NPI:1689403495
Name:SMITH, ELIZABETH KATHLEEN (PHD, LMHC, LPC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:KATHLEEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PGA BLVD APT 331
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2783
Mailing Address - Country:US
Mailing Address - Phone:561-232-5718
Mailing Address - Fax:
Practice Address - Street 1:2100 PGA BLVD APT 331
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33408-2783
Practice Address - Country:US
Practice Address - Phone:561-232-5718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18876101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health