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Individual

JOHN ANDREW SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC, CASC, ICS

Contact information

Practice address
300 FEMRITE DR, MONONA, WI 53716-3716
(608) 222-7311
Mailing address
300 FEMRITE DR, TELLURIAN UCAN, MONONA, WI 53716-3561
(608) 222-7311

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1772-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3299-125
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
7107-135
WI
101YM0800X
Mental Health Counselor
3299-125
WI

Other

Enumeration date
07/13/2009
Last updated
07/13/2009
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