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Individual
JOHN ANDREW SMITH
Active
Individual
JOHN ANDREW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CASC, ICS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1772-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3299-125
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
7107-135
WI
101YM0800X
Mental Health Counselor
3299-125
WI
Other
Enumeration date
07/13/2009
Last updated
07/13/2009
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