| Doctor Name: | NOELLE SMITH |
| NPI Number: | 1104146794 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CASAC, MA |
| License Number: | 24342 |
| Business Practice Address: | 6207 Woodside Ave 4th Floor Woodside, NY - 113773653 |
| Business Phone Number: | 7188985085 |
| Business Fax Number: | 7188985582 |
| Mailing Address: | 6207 Woodside Ave, 4th Floor WOODSIDE |
| State: | NY |
| Postal Code: | 113773653 |
| Phone Number: | 7188985085 |
| Fax Number: | 7188985582 |
| NPI Enumeration Date: | 06/04/2010 |
| NPI Last Update Date: | 06/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 24342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |