Individual
MS. ANGELA MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S, LICDC, CFRC
Contact information
Practice address
15 W MAIN ST, MADISON, OH 44057-3125
(440) 413-3392
Mailing address
15 W MAIN ST, MADISON, OH 44057-3125
(440) 428-0118
(440) 417-0119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
161774
OH
1041C0700X
Clinical Social Worker
Primary
I.2002366
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0380450
—
OH
Enumeration date
11/20/2019
Last updated
10/09/2023
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