MEDICARE: DR. JENNIFER B SMIRNOFF PHD, LPCC-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	E 0004163	OH

General Provider Information

NPI Number	:	1538387451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER B SMIRNOFF PHD, LPCC-S

Provider Business Mailing Address
First Line	:	1715 INDIAN WOOD CIR
Second Line	:	SUITE 200
City	:	MAUMEE
State	:	OH
Zip	:	43537-4055
Country	:	US
Telephone Number	:	419-509-8670
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 INDIAN WOOD CIR
Second Line	:	SUITE 200
City	:	MAUMEE
State	:	OH
Zip	:	43537-4055
Country	:	US
Telephone Number	:	419-509-8670
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	03/17/2026

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