Healthcare Provider Details

I. General information

NPI: 1386548022
Provider Name (Legal Business Name): AMY B SMITH MFTC & LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9447 NIWOT RD
NIWOT CO
80503-7247
US

IV. Provider business mailing address

560 PIKES VIEW DR
ERIE CO
80516-6420
US

V. Phone/Fax

Practice location:
  • Phone: 720-526-2204
  • Fax:
Mailing address:
  • Phone: 808-463-9327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTC.0014994
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: