Provider Demographics
NPI:1679613350
Name:SMITH, CARYN SCOTT (LPCC)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:SCOTT
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 MARYMONT DR
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-4228
Mailing Address - Country:US
Mailing Address - Phone:937-773-4010
Mailing Address - Fax:
Practice Address - Street 1:405 PUBLIC SQ
Practice Address - Street 2:SUITE 243
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-3272
Practice Address - Country:US
Practice Address - Phone:937-335-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002495101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health