MEDICARE: MICHAEL DORIAN SMITH PHD

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
1	101YP2500X	Professional Counselor	0701000583	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	084256	OTHER	VA	SENTARA
2	082305	OTHER	VA	ANTHEM BCBS OF VIRGINIA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	87647	OTHER	MN	CIGNA

General Provider Information

NPI Number	:	1124073853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DORIAN SMITH PHD

Provider Business Mailing Address
First Line	:	1241 MALL DRIVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-4737
Country	:	US
Telephone Number	:	804-794-8828
Fax Number	:

Provider Business Practice Location Address
First Line	:	1241 MALL DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-4737
Country	:	US
Telephone Number	:	804-794-8828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	04/17/2019

Similar Medicare Providers

1295786390 — DR. TERESA ANN BUCZEK PH,D.
Practice Location Address:

1241 MALL DR
RICHMOND, VA
23235-4737

Practice Phone: 804-794-5928
Practice Fax: 804-379-6385

1336161520 — DR. WILLIAM DAVID BROCK PH.D.
Practice Location Address:

1241 MALL DR
RICHMOND, VA
23235-4737

Practice Phone: 804-794-8828
Practice Fax: 804-794-4735

1962515114 — MS. PATRICIA LEIGH WINTERBERGER BROCK LPC
Practice Location Address:

1241 MALL DR
RICHMOND, VA
23235-4737

Practice Phone: 804-306-8458
Practice Fax: 804-794-4735

1982277117 — DR. KIMONE LATOYA JOHNS DNP, FNP-BC, PMHNP-B
Practice Location Address:

1233 MALL DR
NORTH CHESTERFIELD, VA
23235-4737

Practice Phone: 917-856-6295
Practice Fax:

1790058899 — DR. ALAN THOMAS VON KLEISS PSYD
Practice Location Address:

1215 MALL DR
NORTH CHESTERFIELD, VA
23235-4737

Practice Phone: 804-594-3690
Practice Fax: 804-794-7374

1326415837 — DR. RAE-ANNE DOUGAN
Practice Location Address:

1215 MALL DR
NORTH CHESTERFIELD, VA
23235-4737

Practice Phone: 804-594-3960
Practice Fax:

Directions to “ MICHAEL DORIAN SMITH PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.