Healthcare Provider Details

I. General information

NPI: 1538095351
Provider Name (Legal Business Name): HENRY M L SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1081 N MARION ST
DENVER CO
80218-3016
US

IV. Provider business mailing address

1081 N MARION ST
DENVER CO
80218-3016
US

V. Phone/Fax

Practice location:
  • Phone: 240-234-4436
  • Fax:
Mailing address:
  • Phone: 240-234-4436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0024878
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: