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General NPI Number Information
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NPI Number | 1609280809
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Entity Type | Individual
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Provider Name | PHILIP SMITH LPCC
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Gender | Male
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 2971 GRAHAM RD
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City | STOW
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State | OH
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Zip | 44224-3619
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Country | US
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Telephone | 330-688-7981
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Fax | 330-688-7469
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Provider Business Mailing Address
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Address Line | PO BOX 932909
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City | CLEVELAND
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State | OH
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Zip | 44193-2909
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Country | US
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Telephone | 330-854-4281
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Fax | 330-854-0032
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.1200557
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License Number State | OH
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