Provider Demographics
NPI:1124239884
Name:WATTS-SMITH, OLGA O (LCPC)
Entity type:Individual
Prefix:MS
First Name:OLGA
Middle Name:O
Last Name:WATTS-SMITH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2137 S FINLEY RD
Mailing Address - Street 2:1016
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6465
Mailing Address - Country:US
Mailing Address - Phone:630-967-4705
Mailing Address - Fax:
Practice Address - Street 1:1979 N MILL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1200
Practice Address - Country:US
Practice Address - Phone:630-428-2344
Practice Address - Fax:630-428-2308
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health