Individual
DARCELMARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,CADC,MISA
Contact information
Practice address
839 BROADWAY STE 104, GARY, IN 46402-2414
(219) 882-4010
Mailing address
839 BROADWAY STE 104, GARY, IN 46402-2414
(219) 882-4010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
29680
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
IL
101YM0800X
Mental Health Counselor
Primary
30643
IL
175T00000X
Peer Specialist
34964
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29680
CADC
IL
01
—
30643
MISA
IL
Enumeration date
11/27/2013
Last updated
06/15/2021
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