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Individual

STEPHANIE ANN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
Primary
L5963
OR
1041C0700X
Clinical Social Worker
13644
SC

Other

Enumeration date
12/16/2010
Last updated
08/30/2023
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