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General NPI Number Information
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NPI Number | 1275301749
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Entity Type | Organization
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Legal Business Name | WOODSMITH COUNSELING LLC
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Dates
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Enumeration Date | 12/14/2023
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 272 HARBOR WAY
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City | ANN ARBOR
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State | MI
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Zip | 48103-6668
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Country | US
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Telephone | 269-873-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 1918 STEARNS AVE
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City | KALAMAZOO
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State | MI
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Zip | 49008-1844
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRISTAN WOODSMITH
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Credential | MSW
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Telephone | 269-873-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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