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NPI Code Detail

MEDICARE: VERNTONN TERRELL SMITH

MEDICARE: VERNTONN TERRELL SMITH
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
1101YP2500XProfessional CounselorE.2303626OH
2101YP2500XProfessional Counselor1500422OH

General Provider Information

NPI Number : 1750803581
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERNTONN TERRELL SMITH
Provider Business Mailing Address
First Line : 1341 E 279TH ST APT 202E
Second Line :
City : EUCLID
State : OH
Zip : 44132-3091
Country : US
Telephone Number : 216-633-2505
Fax Number :
Provider Business Practice Location Address
First Line : 3100 E 45TH ST STE 212
Second Line :
City : CLEVELAND
State : OH
Zip : 44127-1093
Country : US
Telephone Number : 216-341-5510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2017
Last Update Date : 12/26/2023

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Directions to “ VERNTONN TERRELL SMITH ” Practice Location

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