Healthcare Provider Details

I. General information

NPI: 1336086826
Provider Name (Legal Business Name): EMMA SMITH MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BEDFORD ST STE 2400
LEXINGTON MA
02420-1544
US

IV. Provider business mailing address

450 BEDFORD ST STE 2400
LEXINGTON MA
02420-1544
US

V. Phone/Fax

Practice location:
  • Phone: 781-633-7779
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: