Individual
JOHNNIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
7459 BURLINGTON PIKE, FLORENCE, KY 41042-1553
(859) 331-3292
(859) 578-2864
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3200
(859) 578-3273
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
166689
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
12/27/2013
Last updated
04/27/2017
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