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General NPI Number Information
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NPI Number | 1871391441
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Entity Type | Individual
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Provider Name | MICHAEL LEWIS SMITH LMSW, LMFT
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Gender | Male
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 24455 CROCKER BLVD
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City | CLINTON TWP
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State | MI
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Zip | 48036-3260
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Country | US
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Telephone | 989-596-3544
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 N RIVER RD
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City | SAGINAW
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State | MI
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Zip | 48609-6832
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Country | US
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Telephone | 989-596-3544
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801057200
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101005426
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License Number State | MI
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