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General NPI Number Information
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NPI Number | 1508350828
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Entity Type | Individual
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Provider Name | KANDYCE D SMITH
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Gender | Female
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 3500 CARNEGIE AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-2641
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Country | US
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Telephone | 440-269-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 ROCKSIDE RD STE 100
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2148
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C1801449
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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