Individual
MRS. GINA M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-SUPV
Contact information
Practice address
6570 SOSNA DR, FAIRFIELD, OH 45014-2222
(513) 942-4673
(513) 737-1107
Mailing address
3103 DIXIE HWY, HAMILTON, OH 45015-1653
(513) 892-4673
(513) 737-1107
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
090627
OH
101YM0800X
Mental Health Counselor
Primary
E.0500056 SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090627
CDCA
OH
01
—
E.0500056 SUPV
LPCC
OH
Enumeration date
10/01/2010
Last updated
05/18/2022
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