Provider Demographics
NPI:1942505540
Name:SMITH, JANET CAROL (LMSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:CAROL
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W LUDINGTON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2021
Mailing Address - Country:US
Mailing Address - Phone:231-425-4008
Mailing Address - Fax:
Practice Address - Street 1:11326 HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:HOLTON
Practice Address - State:MI
Practice Address - Zip Code:49425-9752
Practice Address - Country:US
Practice Address - Phone:231-894-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801891651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical