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Individual

MR. LARRY L. SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSCSW LCAC

Contact information

Practice address
1037 W MUNNELL ST, WICHITA, KS 67213-4542
(316) 617-2987
Mailing address
524 N BAEHR ST, WICHITA, KS 67212-2220

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
AAPS CERTIFICATION
KS
1041C0700X
Clinical Social Worker
Primary
4190
KS
1041C0700X
Clinical Social Worker
KS

Other

Enumeration date
07/21/2008
Last updated
04/11/2022
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