Provider Demographics
NPI:1740769025
Name:SMITH, JOSEPH WHEELER (MS, LMFT 130853)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WHEELER
Last Name:SMITH
Suffix:
Gender:M
Credentials:MS, LMFT 130853
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 2215
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-2215
Mailing Address - Country:US
Mailing Address - Phone:530-864-0173
Mailing Address - Fax:
Practice Address - Street 1:95 DECLARATION DR STE 5
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4916
Practice Address - Country:US
Practice Address - Phone:530-343-8834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130853101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health