Individual
VICKI LYNN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16457132
WI
1041C0700X
Clinical Social Worker
Primary
7788-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100030733
—
WI
Enumeration date
06/11/2013
Last updated
02/02/2023
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