Provider Demographics
NPI:1407748189
Name:SMITH, QUIN'TANAY TEONA-LEE (LSW)
Entity type:Individual
Prefix:
First Name:QUIN'TANAY
Middle Name:TEONA-LEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 DEER CREEK DR STE 9
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-8089
Mailing Address - Country:US
Mailing Address - Phone:502-435-9889
Mailing Address - Fax:
Practice Address - Street 1:10123 ALLIANCE RD STE 300
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-4887
Practice Address - Country:US
Practice Address - Phone:513-841-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.25125961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical