Provider Demographics
NPI:1497348924
Name:BROWN-SMITH, VICKIE (CDCIII)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:BROWN-SMITH
Suffix:
Gender:F
Credentials:CDCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 VINE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-7094
Mailing Address - Country:US
Mailing Address - Phone:513-599-2000
Mailing Address - Fax:
Practice Address - Street 1:1435 VINE ST APT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-7094
Practice Address - Country:US
Practice Address - Phone:513-599-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII.011358101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)