Provider Demographics
NPI:1851502496
Name:SMITH, STEFFENY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:STEFFENY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 RIDGE RD APT 1H
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-3281
Mailing Address - Country:US
Mailing Address - Phone:773-720-2323
Mailing Address - Fax:
Practice Address - Street 1:2550 CRAWFORD AVE STE 18
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4983
Practice Address - Country:US
Practice Address - Phone:773-720-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490078851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical