Provider Demographics
NPI:1710124938
Name:SMITHCHILD, JUDITH (LPCC-S, LICDC-S, NCC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:SMITHCHILD
Suffix:
Gender:F
Credentials:LPCC-S, LICDC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 SANDHILL RD
Mailing Address - Street 2:(FORMER RENO SCHOOL)
Mailing Address - City:RENO
Mailing Address - State:OH
Mailing Address - Zip Code:45773-8005
Mailing Address - Country:US
Mailing Address - Phone:740-592-5689
Mailing Address - Fax:740-593-7166
Practice Address - Street 1:17 BLUE LINE DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2325
Practice Address - Country:US
Practice Address - Phone:740-592-5689
Practice Address - Fax:740-593-7166
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH90469101YA0400X
OHE.000224-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)