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NPI Code Detail

MEDICARE: TENEA SMITH

MEDICARE: TENEA SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101Y00000XCounselor
3101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1043468978
Entity Type Code : Individual
Provider Name (Legal Business Name) : TENEA SMITH
Provider Business Mailing Address
First Line : PO BOX 1121
Second Line :
City : ROSEBURG
State : OR
Zip : 97470-0254
Country : US
Telephone Number : 541-672-2691
Fax Number :
Provider Business Practice Location Address
First Line : 150 S WALL ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-3233
Country : US
Telephone Number : 360-531-2099
Fax Number : 360-531-2099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2008
Last Update Date : 02/02/2026

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Directions to “ TENEA SMITH ” Practice Location

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