=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720325285
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SMITHEY COUNSELING SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2013
-----------------------------------------------------
Last Update Date | 07/16/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3209 W SMITH VALLEY RD SUITE 108
-----------------------------------------------------
City | GREENWOOD
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46142-8495
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-771-3839
-----------------------------------------------------
Fax | 317-884-8929
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4797 TIMBER CREEK LN
-----------------------------------------------------
City | MARTINSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46151-6591
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-771-3839
-----------------------------------------------------
Fax | 317-884-8929
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ADAM R. SMITHEY
-----------------------------------------------------
Credential | PHD, LMFT
-----------------------------------------------------
Telephone | 317-771-3839
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 35001852A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------