Provider Demographics
NPI:1306673603
Name:SMITS, TORI KORIN (LSW)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:KORIN
Last Name:SMITS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 VERSAILLES DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-6801
Mailing Address - Country:US
Mailing Address - Phone:708-642-8927
Mailing Address - Fax:
Practice Address - Street 1:350 INDIAN BOUNDARY RD
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1511
Practice Address - Country:US
Practice Address - Phone:708-642-8927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33012107A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker