MEDICARE: DR JENNIFER G SMITH LLC

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1659243343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR JENNIFER G SMITH LLC

Provider Business Mailing Address
First Line	:	670 MERIDIAN WAY STE 151
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-2302
Country	:	US
Telephone Number	:	614-701-7987
Fax Number	:

Provider Business Practice Location Address
First Line	:	670 MERIDIAN WAY STE 151
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-2302
Country	:	US
Telephone Number	:	614-701-7987
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER GABRIELLE SMITH
Credential	:	PSYD
Telephone Number	:	614-701-7987

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	09/22/2025

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