Individual
JASON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 COURT ST, PORTSMOUTH, OH 45662-3932
(740) 354-6685
Mailing address
411 COURT ST, PORTSMOUTH, OH 45662-3932
(740) 354-8135
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.173338
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCII.161809
OH
101YM0800X
Mental Health Counselor
QMHS
OH
1041C0700X
Clinical Social Worker
S.2411745
OH
Other
Enumeration date
05/05/2020
Last updated
12/26/2024
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