Provider Demographics
NPI:1457925562
Name:KIRKPATRICK-SMITH, CASSIE ANN (LPCC)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:ANN
Last Name:KIRKPATRICK-SMITH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 E MCMICKEN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-6625
Mailing Address - Country:US
Mailing Address - Phone:513-316-7402
Mailing Address - Fax:
Practice Address - Street 1:40 E MCMICKEN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-6625
Practice Address - Country:US
Practice Address - Phone:513-316-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2303575101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH101YP2500XMedicaid