Individual
JENNIFER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1101 VETERANS DR, LEXINGTON, KY 40502-2235
(859) 233-4511
Mailing address
4696 MARYDALE RD, LONDON, KY 40741-8634
(606) 813-6033
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3817
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14396184
CAQH ID
—
Enumeration date
01/30/2015
Last updated
03/17/2019
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