| Doctor Name: | BRENDA MCGILLIVRAY SMITH |
| NPI Number: | 1750345310 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC LMFT |
| License Number: | 0701002606 |
| Business Practice Address: | 1155 Early Dr Broadway, VA - 22815 |
| Business Phone Number: | 5409019000 |
| Business Fax Number: | 5409019000 |
| Mailing Address: | 1155 Early Dr, BROADWAY |
| State: | VA |
| Postal Code: | 22815 |
| Phone Number: | 5409019000 |
| Fax Number: | 5409019000 |
| NPI Enumeration Date: | 04/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701002606 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |