Provider Demographics
NPI:1568283349
Name:SMITH, BRANDEE A (MSSW, LSW)
Entity type:Individual
Prefix:MRS
First Name:BRANDEE
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 COUNTY LINE RD W STE D
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7247
Mailing Address - Country:US
Mailing Address - Phone:440-360-7500
Mailing Address - Fax:
Practice Address - Street 1:128 COUNTY LINE RD W STE D
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7247
Practice Address - Country:US
Practice Address - Phone:440-360-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSC12004351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical