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NPI Code Detail

MEDICARE: ALANDRIUS SMITH

MEDICARE: ALANDRIUS 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
1101Y00000XCounselor
2103K00000XBehavior Analyst
3171M00000XCase Manager/Care Coordinator
4251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1053853119
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALANDRIUS SMITH
Provider Business Mailing Address
First Line : 2696 MATOGROSO LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-1539
Country : US
Telephone Number : 702-305-0652
Fax Number :
Provider Business Practice Location Address
First Line : 3831 W CHARLESTON BLVD STE 318
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1859
Country : US
Telephone Number : 318-669-9383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2016
Last Update Date : 06/05/2023

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Directions to “ ALANDRIUS SMITH ” Practice Location

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