DR. ODETTA SMILEY PSYD LPC CCMHCMAC NPI 1194082818

NPI Information

NPI: 1194082818
Provider Name: DR. ODETTA SMILEY, PSYD, LPC, CCMHC,MAC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
508 N MAIN ST STE A
HINESVILLE, GA
ZIP 31313
Phone: (912) 785-2100
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DR. Odetta Smiley, PSYD, LPC, CCMHC,MAC is a professional counselor in Hinesville, GA. DR. Odetta Smiley, PSYD, LPC, CCMHC,MAC NPI is 1194082818. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

508 N MAIN ST STE A
HINESVILLE, GA
ZIP 31313-570
Phone: (912) 785-2100
Fax: (844) 848-5854

The enumeration date for this NPI number is 4/19/2012 and was last updated on 5/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	507430		No
2	103T00000X	Psychologist				No
3	101YP2500X	Counselor	Professional	LPC004492	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003140039A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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