Individual
CONSTANCE SALLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, LPCC
Contact information
Practice address
2120 PARK AVE, MINNEAPOLIS, MN 55404-3378
(651) 774-0011
(651) 774-0606
Mailing address
3000 AMES CROSSING RD STE 600, EAGAN, MN 55121-2519
(651) 774-0011
(651) 774-0606
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302730
MN
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/22/2011
Last updated
12/12/2023
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