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General NPI Number Information
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NPI Number | 1588941561
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Entity Type | Organization
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Legal Business Name | SMITHSON CLINIC, INC.
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 2825 VALLEJO ST
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City | DENVER
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State | CO
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Zip | 80211-4312
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Country | US
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Telephone | 303-762-8994
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Fax | 720-855-3710
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Provider Business Mailing Address
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Address Line | 2825 VALLEJO ST
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City | DENVER
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State | CO
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Zip | 80211-4312
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Country | US
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Telephone | 303-762-8994
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Fax | 720-855-3710
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. MELANIE BETH SMITHSON
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Credential | LPC, BCDMT
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Telephone | 303-762-8994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC 904
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 448
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License Number State | CO
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