| Doctor Name: | MR. WALTER KENNETH SMITH |
| NPI Number: | 1073615332 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.C. |
| License Number: | C4405 |
| Business Practice Address: | 57 South State Street Painesville, OH - 44077 |
| Business Phone Number: | 4403576740 |
| Business Fax Number: | |
| Mailing Address: | 2099 Lakeland Ave, LAKEWOOD |
| State: | OH |
| Postal Code: | 441075713 |
| Phone Number: | 2162216411 |
| Fax Number: | |
| NPI Enumeration Date: | 09/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | C4405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |