MEDICARE: MRS. HELEN FRANKLIN SMITH LICDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	954413	OH

General Provider Information

NPI Number	:	1629395306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HELEN FRANKLIN SMITH LICDC

Provider Business Mailing Address
First Line	:	1503 RUNAWAY BAY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204
Country	:	US
Telephone Number	:	614-487-0556
Fax Number	:

Provider Business Practice Location Address
First Line	:	1503 RUNAWAY BAY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-4814
Country	:	US
Telephone Number	:	614-487-0556
Fax Number	:

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

Provider Enumeration Date	:	04/21/2010
Last Update Date	:	04/21/2010

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