Healthcare Provider Details

I. General information

NPI: 1003462961
Provider Name (Legal Business Name): ASHLEIGH SMITH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEIGH PRELESNIK

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS MI
49546-5794
US

IV. Provider business mailing address

1019 MERRITT ST SE
GRAND RAPIDS MI
49507-3347
US

V. Phone/Fax

Practice location:
  • Phone: 510-495-0756
  • Fax:
Mailing address:
  • Phone: 616-403-9836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: