Smith, Kenneth Brace
Smith, Kenneth Brace is an individual health care provider with primary practice located at 1062 State Route 38 , Owego NY 13827. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Smith, Kenneth Brace can be contacted via phone (607) 687-4000.Contact Information
Primary practice address
1062 State Route 38
Owego NY 13827
Phone: (607) 687-4000
Fax: (607) 687-6396
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 069846-1 | New York |
Profile Details
| NPI number | 1609921279 |
|---|---|
| LBN Legal business name | Smith, Kenneth Brace |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2007 |
| Last updated | Jul 9th, 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 | 1609921279 | NPPES |
| New York | Other | 069846-1 | LCSW LICENSE NUMBER |
| New York | MEDICAID | 00618162 | LCSW LICENSE NUMBER |
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