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Individual
MARY DANIELLE SMITH
Active
Individual
MARY DANIELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICDC, QMHS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.162003
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.162215
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
QMHS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0381739
—
OH
Enumeration date
10/17/2017
Last updated
02/03/2023
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