Provider Demographics
NPI:1689622037
Name:SMITH, RENEE FITCH (LPC)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:FITCH
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4184
Mailing Address - Country:US
Mailing Address - Phone:843-661-6030
Mailing Address - Fax:843-679-2633
Practice Address - Street 1:1803 CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4184
Practice Address - Country:US
Practice Address - Phone:843-661-6030
Practice Address - Fax:843-679-2633
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional