MEDICARE: MS. NANCY JO SMUCKER LISW LPCC

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	1041C0700X	Clinical Social Worker	I0001875	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000289839	OTHER	OH	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1871540419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY JO SMUCKER LISW LPCC

Provider Business Mailing Address
First Line	:	2371 WESTERN OHIO AVENUE
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45805
Country	:	US
Telephone Number	:	419-228-4555
Fax Number	:	419-228-2717

Provider Business Practice Location Address
First Line	:	2371 WESTERN OHIO AVENUE
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45805
Country	:	US
Telephone Number	:	419-228-4555
Fax Number	:	419-228-2717

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	05/31/2026

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