| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LINDA R SMITH, OWNER, DIRECTOR & ADM. | 1225450802 | 2024-11-09 |
Linda R Smith, Owner, Director & Adm. is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225450802. Registration indicates Linda R Smith, Owner, Director & Adm. is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Linda R Smith, Owner, Director & Adm. OFFICIAL AGENCY |
| Other Provider Name | Linda Ruth Smith |
| Practice Office Address | 1324 TROTWOOD AVE STE 11 COLUMBIA, TN US |
| Practice Office Telephone | 9312152182 |
| Practice Office Fax | 9313815363 |
| Mailing Address | 100 N BIGBY DR COLUMBIA, TN 384014704 US |
| Business Telephone | 9312152182 |
| Business Fax | 9313815363 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 100 N Bigby Dr | Columbia, TN 384014704 | 9312152182 / 9319010205 |
| Company email [] | [email protected] | Direct Legacy Life Care Programs 501 c 3 Corporation |
| Code | Practice | License No State |
|---|---|---|
| 101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor | L000000036622
TN |
| 1962746842 | MEDICAID | TN | |
| Q0006613 | MEDICAID | TN | |
| 1225450802 | OTHER | TN | MENTAL HEALTH O |
| TN-Q006613 | MEDICAID | TN |