Provider Demographics
NPI:1003175704
Name:SMETANA, TODD J (LPC-UNDER SUPERVISIO)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:J
Last Name:SMETANA
Suffix:
Gender:M
Credentials:LPC-UNDER SUPERVISIO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 S HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-7116
Mailing Address - Country:US
Mailing Address - Phone:918-519-2833
Mailing Address - Fax:
Practice Address - Street 1:5550 S GARNETT RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-6831
Practice Address - Country:US
Practice Address - Phone:918-665-6501
Practice Address - Fax:918-665-3966
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor