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Individual

MR. JASON C SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
111 S 1ST ST STE 160, MADISON, WI 53704-5246
(608) 977-1864
(608) 255-2752
Mailing address
111 S 1ST ST STE 160, MADISON, WI 53704-5246
(608) 977-1864
(608) 255-2752

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
166.001089
IL
106H00000X
Marriage & Family Therapist
1889
MN
106H00000X
Marriage & Family Therapist
Primary
949-124
WI

Other

Enumeration date
08/26/2009
Last updated
07/21/2022
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