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Ethan Smith
Mental Health Counselor in Bloomington, Indiana
NPI 1609457597

Ethan Smith is a Mental Health Counselor based in Bloomington, IN and is specialized in Mental Health. Ethan Smith practices in Bloomington, IN. The NPI Number for Ethan Smith is 1609457597 and holds a License No. 39003923A (Indiana).

The current practice location address for Ethan Smith is 420 S Landmark Ave, Bloomington, IN and can be reached out via phone at 812-369-4333.

Location: 420 S Landmark Ave, Bloomington, IN, 47403-5000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609457597
Provider Name
Ethan Smith
Credential
Provider Entity Type
Individual
Gender
Male
Address
420 S Landmark Ave, Bloomington, IN, 47403-5000
Phone Number
812-369-4333
Fax Number
Provider Enumeration Date
04/21/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
420 S Landmark Ave
City
Bloomington
State
Indiana
Zip
47403-5000
Phone Number
812-369-4333
Fax Number
person
Provider Business Mailing Address Details
Address
420 S Landmark Ave
City
Bloomington
State
Indiana
Zip
47403-5000
Phone Number
812-369-4333
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
39003923A (Indiana)
Definition
Definition to come...
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