MEDICARE: TESSA SMITH

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
1	101YM0800X	Mental Health Counselor	LPCC.0022876	CO

General Provider Information

NPI Number	:	1629928080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESSA SMITH

Provider Business Mailing Address
First Line	:	2020 CARIBOU DR STE 101
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-4352
Country	:	US
Telephone Number	:	970-829-8780
Fax Number	:

Provider Business Practice Location Address
First Line	:	4025 AUTOMATION WAY STE 4
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3446
Country	:	US
Telephone Number	:	970-829-8780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ TESSA SMITH ” Practice Location

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