Individual ProviderBrandy Lynn SmithCounselorBehavioral Health & Social Service ProvidersPractice Address60 S State Route 157, Edwardsville, IL 62025-3846(000) 000-0000PECOS EnrollmentBased on the most recent information from CMS, provider Brandy Lynn Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1598421703Provider TypeIndividualFull NameSmith, Brandy LynnCredentialLCPCGenderFemaleSole ProprietorNoEnumeration Date11/11/2021Last Updated4/11/2024Contact InformationPractice LocationPractice Address60 S State Route 157, Edwardsville, IL 62025-3846Phone(000) 000-0000FaxUnlisted FaxMailing LocationMailing Address60 S State Route 157, Edwardsville, IL 62025-3846PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense180.014158IllinoisCode101YP2500XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense178.014623Illinois