Individual ProviderJohnnie SmithCounselorBehavioral Health & Social Service ProvidersPractice Address7459 Burlington Pike, Florence, KY 41042-1553(859) 331-3292(859) 578-3200PECOS EnrollmentBased on the most recent information from CMS, provider Johnnie Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1639590235Provider TypeIndividualFull NameSmith, JohnnieCredentialLPCCGenderMaleSole ProprietorNoEnumeration Date12/27/2013Last Updated4/27/2017Contact InformationPractice LocationPractice Address7459 Burlington Pike, Florence, KY 41042-1553Phone(859) 331-3292Fax(859) 578-2864Mailing LocationMailing Address502 Farrell Dr, Covington, KY 41011-3717Phone(859) 578-3200Fax(859) 578-3273Provider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense166689KentuckyProvider IdentifiersIDDescriptionIssuerID610661458DescriptionOtherIssuerTAX IDKentucky