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Individual

RICHARD SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3562 E US HIGHWAY 30, WARSAW, IN 46580-6720
(574) 372-4489
Mailing address
16965 HAMPTON DR, GRANGER, IN 46530-9177
(224) 908-8128

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99128465A
IN
101YP2500X
Professional Counselor
6401223648
MI
101YP2500X
Professional Counselor

Other

Enumeration date
11/09/2021
Last updated
12/13/2024
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