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NPI Code Detail

MEDICARE: PATRICIA ANN SMITH LMSW

MEDICARE: PATRICIA ANN SMITH LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorM-2046NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215049234
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA ANN SMITH LMSW
Provider Business Mailing Address
First Line : 700 FRIEDMAN AVE
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4231
Country : US
Telephone Number : 505-454-5100
Fax Number :
Provider Business Practice Location Address
First Line : 700 FRIEDMAN AVE
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4231
Country : US
Telephone Number : 505-454-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ PATRICIA ANN SMITH LMSW” Practice Location

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