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General NPI Number Information
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NPI Number | 1548379266
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Entity Type | Individual
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Provider Name | STEPHANIE JANE SMITH LPC
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 90 S PARK ST STE 30
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City | WILLIMANTIC
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State | CT
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Zip | 06226-3336
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Country | US
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Telephone | 860-208-6436
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Fax | 860-423-5353
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Provider Business Mailing Address
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Address Line | 71 CARD ST
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City | WILLIMANTIC
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State | CT
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Zip | 06226-3217
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Country | US
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Telephone | 860-208-6436
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Fax | 860-423-5353
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 001292
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License Number State | CT
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