| Doctor Name: | BENJAMIN SMITH |
| NPI Number: | 1033579271 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | PLC6350 |
| Business Practice Address: | 1108 Sterlington Hwy Farmerville, LA - 712413812 |
| Business Phone Number: | 3183689118 |
| Business Fax Number: | |
| Mailing Address: | 1108 Sterlington Hwy, FARMERVILLE |
| State: | LA |
| Postal Code: | 712413812 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/01/2016 |
| NPI Last Update Date: | 03/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | PLC6350 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |