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Individual

MR. DONALD F SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ACSW, LCSW

Contact information

Practice address
3266 MALLARD COVE LN, FORT WAYNE, IN 46804-2883
(260) 436-5986
(260) 436-1859
Mailing address
3266 MALLARD COVE LN, FORT WAYNE, IN 46804-2883
(260) 436-5986
(260) 436-1859

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
34001688A
IN
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000210319
ANTHEM BCBS
IN
01
064062000
MAGELLAN
01
090762
MHN
Enumeration date
03/10/2007
Last updated
02/26/2025
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