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NPI Code Detail

MEDICARE: KYLIE SMITH LPC

MEDICARE: KYLIE SMITH LPC
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
1101Y00000XCounselorC.2405692-TRNEOH
2101YP2500XProfessional CounselorC.2507378OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679389902
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE SMITH LPC
Provider Business Mailing Address
First Line : 4522 FULTON DR NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2332
Country : US
Telephone Number : 330-915-2907
Fax Number : 330-915-2958
Provider Business Practice Location Address
First Line : 4522 FULTON DR NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2332
Country : US
Telephone Number : 330-915-2907
Fax Number : 330-915-2958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2024
Last Update Date : 02/24/2026

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Directions to “ KYLIE SMITH LPC” Practice Location

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