Individual
JOHANNA E SMOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
9037 SHADY GROVE CT, GAITHERSBURG, MD 20877-1301
(301) 221-0483
Mailing address
1221 BROADWOOD DR, ROCKVILLE, MD 20851-2112
(301) 838-9489
(301) 838-9489
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC2225
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21BNJO
BCBS PROVIDER NUMBER
MD
01
—
5572
BLUECROSS BLUE SHIELD PRO
MD
01
—
LC2225
MD LICENSED PROFFESSIONAL
MD
Enumeration date
03/19/2007
Last updated
07/01/2008
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