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NPI Code Detail

MEDICARE: MR. JEFFREY ALLEN SMART LPCC-S, LICDC

MEDICARE: MR. JEFFREY ALLEN SMART LPCC-S, LICDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE1800894OH

General Provider Information

NPI Number : 1912355579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY ALLEN SMART LPCC-S, LICDC
Provider Business Mailing Address
First Line : 9529 SADDLEBROOK LN APT 1A
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-5524
Country : US
Telephone Number : 937-475-4576
Fax Number :
Provider Business Practice Location Address
First Line : 1411 N FAIRFIELD RD
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2658
Country : US
Telephone Number : 937-426-2686
Fax Number : 937-426-6230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2016
Last Update Date : 10/25/2024

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Directions to “ MR. JEFFREY ALLEN SMART LPCC-S, LICDC” Practice Location

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