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General NPI Number Information
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NPI Number | 1912355579
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Entity Type | Individual
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Provider Name | JEFFREY ALLEN SMART LPCC-S, LICDC
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Gender | Male
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 1411 N FAIRFIELD RD
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City | BEAVERCREEK
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State | OH
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Zip | 45432-2658
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Country | US
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Telephone | 937-426-2686
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Fax | 937-426-6230
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Provider Business Mailing Address
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Address Line | 9529 SADDLEBROOK LN APT 1A
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City | MIAMISBURG
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State | OH
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Zip | 45342-5524
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Country | US
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Telephone | 937-475-4576
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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 | E1800894
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License Number State | OH
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