Provider Demographics
NPI:1871993089
Name:SMITH, BOYCE LEE JR (LCAS)
Entity type:Individual
Prefix:MR
First Name:BOYCE
Middle Name:LEE
Last Name:SMITH
Suffix:JR
Gender:
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 PLANTATION CENTER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5148
Mailing Address - Country:US
Mailing Address - Phone:704-709-4201
Mailing Address - Fax:704-709-4202
Practice Address - Street 1:2435 PLANTATION CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5148
Practice Address - Country:US
Practice Address - Phone:704-709-4201
Practice Address - Fax:704-709-4202
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20214101YA0400X
NCA13552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20214AOtherLCASA