Healthcare Provider Details

I. General information

NPI: 1841794401
Provider Name (Legal Business Name): JENNIFER LEE SMITH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 ALDENGATE DR
GALLOWAY OH
43119-8632
US

IV. Provider business mailing address

2237 LOCKAMY CT
GROVE CITY OH
43123-1563
US

V. Phone/Fax

Practice location:
  • Phone: 614-870-6670
  • Fax:
Mailing address:
  • Phone: 614-779-1425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1801581
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: