Individual
GWEN MARIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHP, LPC, PLADC
Contact information
Practice address
2286 COUNTY ROAD Q, WILBER, NE 68465-2433
(402) 821-2119
Mailing address
2286 COUNTY ROAD Q, WILBER, NE 68465-2433
(402) 821-2119
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
990
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
6488
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-388
NE
101YM0800X
Mental Health Counselor
Primary
1614
NE
104100000X
Social Worker
24497
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47052851500
—
NE
05
—
47052851581
—
NE
01
—
84442
BC/BS
NE
Enumeration date
01/05/2007
Last updated
11/05/2007
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