MEDICARE: AMANDA J SMITH 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1326977893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDA J SMITH LLC

Provider Business Mailing Address
First Line	:	178 STANLEY CIRCLE DIVE
Second Line	:
City	:	ESTES PARK
State	:	CO
Zip	:	80517
Country	:	US
Telephone Number	:	414-430-3134
Fax Number	:

Provider Business Practice Location Address
First Line	:	178 STANLEY CIRCLE DIVE
Second Line	:
City	:	ESTES PARK
State	:	CO
Zip	:	80517
Country	:	US
Telephone Number	:	414-430-3134
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA SMITH
Credential	:
Telephone Number	:	414-430-3134

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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