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General NPI Number Information
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NPI Number | 1730760042
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Entity Type | Individual
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Provider Name | JENNIFER LYNN SMITH LPC
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Gender | Female
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 2060 E ALGONQUIN RD STE 702
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City | SCHAUMBURG
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State | IL
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Zip | 60173-4162
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Country | US
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Telephone | 847-701-4191
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Fax |
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Provider Business Mailing Address
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Address Line | 4915 N LEONARD DR
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City | NORRIDGE
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State | IL
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Zip | 60706-2811
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Country | US
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Telephone | 708-466-1815
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.016679
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License Number State | IL
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