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General NPI Number Information
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NPI Number | 1407368897
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Entity Type | Individual
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Provider Name | WENDY L SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 12834 OLD HWY US 169
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City | OOLOGAH
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State | OK
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Zip | 74053-0000
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Country | US
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Telephone | 918-695-2059
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Fax |
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Provider Business Mailing Address
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Address Line | 18862 SAVAGE CT
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City | COLLINSVILLE
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State | OK
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Zip | 74021-6162
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 20477
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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