Provider Demographics
NPI:1457717571
Name:SMITH, HOLLY MICHELLE (LPCC-S, LICDC-CS)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MICHELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPCC-S, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 OAKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-7613
Mailing Address - Country:US
Mailing Address - Phone:614-259-8709
Mailing Address - Fax:614-569-2331
Practice Address - Street 1:2602 OAKSTONE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-7613
Practice Address - Country:US
Practice Address - Phone:614-259-8709
Practice Address - Fax:614-259-2331
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.161354101YA0400X
OHE.0500661- SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)