Healthcare Provider Details

I. General information

NPI: 1417462383
Provider Name (Legal Business Name): JENNIFER LYNN SMITH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 FRANK LLOYD WRIGHT DRIVE SUITE L-4000
ANN ARBOR MI
48105
US

IV. Provider business mailing address

5229 W MICHIGAN AVE LOT 343
YPSILANTI MI
48197-9170
US

V. Phone/Fax

Practice location:
  • Phone: 734-999-8609
  • Fax:
Mailing address:
  • Phone: 313-727-0267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801097699
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: