Healthcare Provider Details

I. General information

NPI: 1457803082
Provider Name (Legal Business Name): ARIEL SMALLWOOD MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIEL ALLEN

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2347 VINE ST
CINCINNATI OH
45219-1745
US

IV. Provider business mailing address

2347 VINE ST
CINCINNATI OH
45219-1745
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-1117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC1300776
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: