Provider Demographics
NPI:1245459312
Name:WEST-SMITH, LISA (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:WEST-SMITH
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636256
Mailing Address - Street 2:CENTRAL CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:UM
Mailing Address - Phone:513-585-5508
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:7690 DISCOVERY DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6542
Practice Address - Country:US
Practice Address - Phone:513-939-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-10391041C0700X
OHI 00075231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical