Provider Demographics
NPI:1013239268
Name:SMITH, JENNIFER (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAMFT
Mailing Address - Street 1:601 E SELTICE WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7638
Mailing Address - Country:US
Mailing Address - Phone:208-717-1798
Mailing Address - Fax:208-625-2077
Practice Address - Street 1:601 E SELTICE WAY STE 203
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7638
Practice Address - Country:US
Practice Address - Phone:208-717-1798
Practice Address - Fax:208-625-2077
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMFT-4980106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist