MEDICARE: NATASHA SMITH PHD

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	106H00000X	Marriage & Family Therapist	MT5420	FL

General Provider Information

NPI Number	:	1427705375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA SMITH PHD

Provider Business Mailing Address
First Line	:	4186 LAGOON SHORE DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-8605
Country	:	US
Telephone Number	:	561-275-9178
Fax Number	:

Provider Business Practice Location Address
First Line	:	4186 LAGOON SHORE DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-8605
Country	:	US
Telephone Number	:	561-275-9178
Fax Number	:

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

Provider Enumeration Date	:	03/09/2022
Last Update Date	:	06/18/2026

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