Provider Demographics
NPI:1265208656
Name:SMITH, JODIE DEAN (LPC-C)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:DEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC-C
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:KATHRYN
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-C
Mailing Address - Street 1:474 MARY BETH RD
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-4347
Mailing Address - Country:US
Mailing Address - Phone:817-688-9406
Mailing Address - Fax:
Practice Address - Street 1:2942 EVERGREEN PKWY STE 200
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-2223
Practice Address - Country:US
Practice Address - Phone:720-432-8508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health