Provider Demographics
NPI:1891894697
Name:SMITH, JO ELLEN (LPC)
Entity type:Individual
Prefix:MS
First Name:JO
Middle Name:ELLEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N LEWIS RUN RD STE 129
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-3058
Mailing Address - Country:US
Mailing Address - Phone:412-469-8220
Mailing Address - Fax:412-469-9365
Practice Address - Street 1:500 N LEWIS RUN RD STE 129
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-3058
Practice Address - Country:US
Practice Address - Phone:412-469-8220
Practice Address - Fax:412-469-9365
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health