Healthcare Provider Details

I. General information

NPI: 1568833499
Provider Name (Legal Business Name): SCOTT ALAN SMITH LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 NW HEATHERWOOD DR
BLUE SPRINGS MO
64015-6450
US

IV. Provider business mailing address

1016 NW HEATHERWOOD DR
BLUE SPRINGS MO
64015-6450
US

V. Phone/Fax

Practice location:
  • Phone: 913-324-3607
  • Fax: 913-780-3387
Mailing address:
  • Phone: 618-694-9272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2021027688
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: