Provider Demographics
NPI:1487720074
Name:SMITH, JULIE D (LISW-S)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:D
Last Name:SMITH
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 COMMERCIAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-9367
Mailing Address - Country:US
Mailing Address - Phone:330-343-7605
Mailing Address - Fax:330-343-3542
Practice Address - Street 1:716 COMMERCIAL AVE SW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-9367
Practice Address - Country:US
Practice Address - Phone:330-343-7605
Practice Address - Fax:330-343-3542
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0010057101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional