Provider Demographics
NPI:1427554328
Name:SMITH, ESTER JEAN (LLBSW)
Entity Type:Individual
Prefix:
First Name:ESTER
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:ESTER
Other - Middle Name:JEAN
Other - Last Name:STIRRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:132 MARQUETTE AVE
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48629-9223
Mailing Address - Country:US
Mailing Address - Phone:989-538-0672
Mailing Address - Fax:
Practice Address - Street 1:655 E CEDAR AVE
Practice Address - Street 2:
Practice Address - City:GLADWIN
Practice Address - State:MI
Practice Address - Zip Code:48624-2215
Practice Address - Country:US
Practice Address - Phone:989-426-9295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2018-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802089883104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker