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General NPI Number Information
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NPI Number | 1629329404
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Entity Type | Individual
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Provider Name | DESILYNN G SMITH MS, LPC, ICS, CSAC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 8901 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1706
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Country | US
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Telephone | 414-265-5770
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Fax | 414-260-8980
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Provider Business Mailing Address
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Address Line | 8751 W BRENTWOOD AVE
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City | MILWAUKEE
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State | WI
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Zip | 53224-5305
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Country | US
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Telephone | 414-526-4981
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Fax | 414-485-7162
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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