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Individual
MR. ROBERT J SMITH
Active
Individual
MR. ROBERT J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
27280
IL
1041C0700X
Clinical Social Worker
Primary
149015944
IL
Other
Enumeration date
09/22/2019
Last updated
09/22/2019
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