MEDICARE: MR. AUSTIN WILLIAM SMYTHE MA, LMFT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	172V00000X	Community Health Worker
3	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1316281298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AUSTIN WILLIAM SMYTHE MA, LMFT

Provider Business Mailing Address
First Line	:	2157 GROVE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-1008
Country	:	US
Telephone Number	:	415-387-2755
Fax Number	:

Provider Business Practice Location Address
First Line	:	91 RAINEY ST APT 845
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-0055
Country	:	US
Telephone Number	:	408-318-2675
Fax Number	:

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

Provider Enumeration Date	:	11/16/2012
Last Update Date	:	10/12/2022

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