MEDICARE: SMITH COUNSELING AND CONSULTANTS

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	LC4957	MD
3	101YM0800X	Mental Health Counselor	LC4957	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376056093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH COUNSELING AND CONSULTANTS

Provider Business Mailing Address
First Line	:	8616 LONICERA CT
Second Line	:
City	:	BRANDYWINE
State	:	MD
Zip	:	20613-3022
Country	:	US
Telephone Number	:	301-399-9875
Fax Number	:

Provider Business Practice Location Address
First Line	:	10230 NEW HAMPSHIRE AVE STE 201
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1423
Country	:	US
Telephone Number	:	301-399-9875
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARCUS SMITH
Credential	:	LPC
Telephone Number	:	301-399-9875

Provider Enumeration Date	:	11/16/2017
Last Update Date	:	05/30/2019

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