Provider Demographics
NPI:1255503678
Name:SMITH, WILLIAM PATRICK (MA, JD LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PATRICK
Last Name:SMITH
Suffix:
Gender:M
Credentials:MA, JD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3598 GLENCAIRN RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5059
Mailing Address - Country:US
Mailing Address - Phone:216-789-1978
Mailing Address - Fax:
Practice Address - Street 1:3598 GLENCAIRN RD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5059
Practice Address - Country:US
Practice Address - Phone:216-789-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC. 0006844101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional