Individual
MR. LARRY WAYNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
141 N SHORTRIDGE RD, INDIANAPOLIS, IN 46219-8906
(317) 644-9900
Mailing address
141 N SHORTRIDGE RD, INDIANAPOLIS, IN 46219-8906
(317) 644-9900
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000511A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201359450
—
IN
Enumeration date
07/21/2006
Last updated
07/25/2016
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