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NPI Code Detail

MEDICARE: ANDREW MICHAEL SMITH LPC

MEDICARE: ANDREW MICHAEL SMITH LPC
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 Counselor12090-125WI
2101YA0400XAddiction (Substance Use Disorder) Counselor17272-131WI

General Provider Information

NPI Number : 1316707755
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW MICHAEL SMITH LPC
Provider Business Mailing Address
First Line : 1111 S 6TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53204-2301
Country : US
Telephone Number : 414-643-8530
Fax Number :
Provider Business Practice Location Address
First Line : 1111 S 6TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53204-2301
Country : US
Telephone Number : 414-643-8530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2024
Last Update Date : 01/05/2026

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Directions to “ ANDREW MICHAEL SMITH LPC” Practice Location

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