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General NPI Number Information
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NPI Number | 1043030240
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH SMOCK MSW, LSW, LMSW
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Gender | Male
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | 8791 WOLFF CT STE 200
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City | WESTMINSTER
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State | CO
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Zip | 80031-3693
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Country | US
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Telephone | 720-583-5256
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Fax |
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Provider Business Mailing Address
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Address Line | 8791 WOLFF CT STE 200
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City | WESTMINSTER
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State | CO
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Zip | 80031-3693
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Country | US
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Telephone | 720-663-8084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 21192
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW.0009925272
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License Number State | CO
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