Healthcare Provider Details

I. General information

NPI: 1508787433
Provider Name (Legal Business Name): BETH ANN SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETH ANN BRANNON

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N MAIN ST
NEW LEXINGTON OH
43764-1264
US

IV. Provider business mailing address

221 N MAIN ST
NEW LEXINGTON OH
43764-1264
US

V. Phone/Fax

Practice location:
  • Phone: 740-342-1991
  • Fax:
Mailing address:
  • Phone: 740-342-1991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: