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General NPI Number Information
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NPI Number | 1417507872
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Entity Type | Organization
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Legal Business Name | JASON SMITH ASSESSMENT AND COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 12/05/2019
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Provider Practice Location Address
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Address Line | 950 OFFICE PARK RD STE 235
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2121
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Country | US
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Telephone | 515-419-1742
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Fax |
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Provider Business Mailing Address
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Address Line | 950 OFFICE PARK RD STE 235
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City | WEST DES MOINES
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State | IA
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Zip | 50265-2121
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Country | US
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Telephone | 515-419-1742
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON W SMITH
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Credential | PSY.D
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Telephone | 515-419-1742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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