Provider Demographics
NPI:1174981666
Name:SMITH-VALENTINE, JARED ALAN (LPC)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:ALAN
Last Name:SMITH-VALENTINE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 SCHROCK RD STE 400
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1174
Mailing Address - Country:US
Mailing Address - Phone:614-987-5620
Mailing Address - Fax:
Practice Address - Street 1:750 E LONG ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1846
Practice Address - Country:US
Practice Address - Phone:614-340-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2025-01-22
Deactivation Date:2024-07-18
Deactivation Code:
Reactivation Date:2025-01-22
Provider Licenses
StateLicense IDTaxonomies
OHC1700293101YP2500X
OHE.1901337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1473276Medicaid