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Edward Michael Smith, LPC-IT
Mental Health Counselor in Dousman, Wisconsin
NPI 1548892821

Edward Michael Smith is a Mental Health Counselor based in Dousman, WI and is specialized in Mental Health. Edward Michael Smith practices in Dousman, WI and has the professional credentials of LPC-IT. The NPI Number for Edward Michael Smith is 1548892821 and holds a License No. 265001 (Wisconsin).

The current practice location address for Edward Michael Smith is W350S1401 Waterville Rd, Dousman, WI and can be reached out via phone at 920-253-1862.

Location: W350S1401 Waterville Rd, Dousman, WI, 53118-9020
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548892821
Provider Name
Edward Michael Smith
Credential
LPC-IT
Provider Entity Type
Individual
Gender
Male
Address
W350S1401 Waterville Rd, Dousman, WI, 53118-9020
Phone Number
920-253-1862
Fax Number
Provider Enumeration Date
02/05/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100060402 05 WI
1114196854 05 WI
institution
Provider Business Practice Location Address Details
Address
W350S1401 Waterville Rd
City
Dousman
State
Wisconsin
Zip
53118-9020
Phone Number
920-253-1862
Fax Number
person
Provider Business Mailing Address Details
Address
W350S1401 Waterville Rd
City
Dousman
State
Wisconsin
Zip
53118-9020
Phone Number
920-253-1862
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
265001 (Wisconsin)
Definition
Definition to come...
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