Smith, Gwen Maria
Smith, Gwen Maria is an sole proprietor health care provider with primary practice located at 2286 County Road Q , Wilber NE 68465-2433. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Smith, Gwen Maria can be contacted via phone (402) 821-2119.Contact Information
Primary practice address
2286 County Road Q
Wilber NE 68465-2433
Phone: (402) 821-2119
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 990 | Nebraska |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | P-388 | Nebraska |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 6488 | Texas |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 1614 | Nebraska |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 24497 | Texas |
Profile Details
| NPI number | 1417004920 |
|---|---|
| LBN Legal business name | Smith, Gwen Maria |
| Credentials | LMHP, LPC, PLADC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Nov 5th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417004920 | NPPES |
| Nebraska | MEDICAID | 47052851581 | |
| Nebraska | MEDICAID | 47052851500 | |
| Nebraska | Other | 84442 |
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