Healthcare Provider Details

I. General information

NPI: 1508612888
Provider Name (Legal Business Name): SMITH LEARNING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 WINDWARD WAY
RICHMOND KY
40475-7709
US

IV. Provider business mailing address

964 SHENANDOAH DR
RICHMOND KY
40475-7032
US

V. Phone/Fax

Practice location:
  • Phone: 859-321-7978
  • Fax:
Mailing address:
  • Phone: 859-582-8982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: OLIVIA WILLIAMS
Title or Position: OWNER, DIRECTOR
Credential: PHD, LPCA
Phone: 859-582-8982