Individual
BRANDEN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW, LICDC
Contact information
Practice address
27511 HOLIDAY LN STE 211, PERRYSBURG, OH 43551-5397
(419) 450-0892
Mailing address
27511 HOLIDAY LN STE 211, PERRYSBURG, OH 43551-5397
(419) 450-0892
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA163104
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162028
OH
1041C0700X
Clinical Social Worker
I.2203743
OH
Other
Enumeration date
09/11/2017
Last updated
01/18/2023
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