Provider Demographics
NPI:1508119991
Name:SMIALEK, JEFFREY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:SMIALEK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 APPLETON PL
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6839
Mailing Address - Country:US
Mailing Address - Phone:813-838-3074
Mailing Address - Fax:
Practice Address - Street 1:1422 APPLETON PL
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-6839
Practice Address - Country:US
Practice Address - Phone:813-838-3074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9288101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health