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Individual
TIMOTHY E SMITH
Active
Individual
TIMOTHY E SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
S0901027
OH
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S0901027
LICENSE
OH
Enumeration date
03/10/2016
Last updated
08/03/2018
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