Individual
LINDA C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT LMHC
Contact information
Practice address
6413 CONSTITUTION DR, FORT WAYNE, IN 46804-1549
(260) 755-5495
(260) 755-5947
Mailing address
6413 CONSTITUTION DR, FORT WAYNE, IN 46804-1549
(260) 755-5495
(260) 755-5947
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39000209A
IN
106H00000X
Marriage & Family Therapist
35001446A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000311148
ANTHEM
—
01
—
0007789215
AETNA US HEALTHCARE
—
01
—
2043493
CIGNA
—
01
—
267336000
MAGELLAN BEHAVIORAL HEALT
—
Enumeration date
09/14/2005
Last updated
10/27/2017
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