Provider Demographics
NPI:1346676657
Name:SMITH, MEARA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MEARA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 N WOLCOTT AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2433
Mailing Address - Country:US
Mailing Address - Phone:909-528-4943
Mailing Address - Fax:
Practice Address - Street 1:3904 N WOLCOTT AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2433
Practice Address - Country:US
Practice Address - Phone:909-528-4943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist