Provider Demographics
NPI:1578980389
Name:SMITH, PAIGE FORRESTER (LMFT, LAC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:FORRESTER
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMFT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3009
Mailing Address - Country:US
Mailing Address - Phone:864-585-0366
Mailing Address - Fax:
Practice Address - Street 1:904 WALNUT GROVE PAULINE RD
Practice Address - Street 2:
Practice Address - City:PAULINE
Practice Address - State:SC
Practice Address - Zip Code:29374-2234
Practice Address - Country:US
Practice Address - Phone:864-590-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC135101YA0400X
SC4627106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)