Ms Kim R Smith, LMHC, LPC | |
210 N Highway 27 Ste 4, Clermont, FL 34711-2411 | |
(352) 708-6283 | |
Not Available |
Full Name | Ms Kim R Smith |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 210 N Highway 27 Ste 4, Clermont, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043274186 | NPI | - | NPPES |
766501600 | Medicaid | FL | |
Z090M | Other | FL | BLUE CROSS BLUE SHIELD # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 7880 (North Carolina) | Primary |
101YM0800X | Counselor - Mental Health | MH8094 (Florida) | Secondary |
Entity Name | Family Life Counseling Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033665260 PECOS PAC ID: 0648623835 Enrollment ID: O20240124000959 |
Mailing Address | Practice Location Address |
---|---|
Ms Kim R Smith, LMHC, LPC 908 Lake Elsie Dr, Tavares, FL 32778-4978 Ph: (352) 409-6540 | Ms Kim R Smith, LMHC, LPC 210 N Highway 27 Ste 4, Clermont, FL 34711-2411 Ph: (352) 708-6283 |
Jomairy Paulino, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2113 Ruby Red Blvd, Clermont, FL 34714 Phone: 352-391-0573 | |
Mrs. Krystie Moss, Counselor Medicare: Medicare Enrolled Practice Location: 210 N Highway 27 Ste 4, Clermont, FL 34711 Phone: 352-708-6283 | |
Paola Andrea Sanchez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2113 Ruby Red Blvd Ste D, Clermont, FL 34714 Phone: 352-394-0573 | |
Jessica Ongko, MS, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2140 N Don Wickham Dr, Clermont, FL 34711 Phone: 352-315-7500 Fax: 352-360-6595 | |
Sherly Rainey, Counselor Medicare: Medicare Enrolled Practice Location: 2113 Ruby Red Blvd Ste D, Clermont, FL 34714 Phone: 352-394-0573 | |
Latoya Tomeka Boyd, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 17011 State Road 50, Clermont, FL 34711 Phone: 850-509-4825 |