Provider Demographics
NPI:1679977664
Name:SMITH, MARGOT (MS, LMFT)
Entity type:Individual
Prefix:
First Name:MARGOT
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 BROOKDALE RD
Mailing Address - Street 2:STE#119
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2771
Mailing Address - Country:US
Mailing Address - Phone:630-717-9408
Mailing Address - Fax:630-778-9490
Practice Address - Street 1:488 N MAIN ST # 2N
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5126
Practice Address - Country:US
Practice Address - Phone:630-296-7073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166000756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health