MEDICARE: SMART IDEAS CONSULTING FIRM, LLC

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	1041C0700X	Clinical Social Worker
2	251S00000X	Community/Behavioral Health Agency	2015007546	MO

General Provider Information

NPI Number	:	1326426479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMART IDEAS CONSULTING FIRM, LLC

Provider Business Mailing Address
First Line	:	9205 NIGHTINGALE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2715
Country	:	US
Telephone Number	:	314-326-3004
Fax Number	:	314-754-9664

Provider Business Practice Location Address
First Line	:	9205 NIGHTINGALE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2715
Country	:	US
Telephone Number	:	314-326-3004
Fax Number	:	314-754-9664

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	LADONNA MICHELLE TURNER
Credential	:	LCSW
Telephone Number	:	314-853-4965

Provider Enumeration Date	:	05/08/2015
Last Update Date	:	02/03/2025

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