Healthcare Provider Details

I. General information

NPI: 1821928904
Provider Name (Legal Business Name): CHRISTOPHER JAMES SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 ANDOVER RD
WESTBROOK ME
04092-3848
US

IV. Provider business mailing address

159 ELM ST APT 208
BIDDEFORD ME
04005-2371
US

V. Phone/Fax

Practice location:
  • Phone: 207-661-6075
  • Fax:
Mailing address:
  • Phone: 607-345-6787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberXL8532
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: