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NPI Code Detail

MEDICARE: PAMELA SMITH MCMHC

MEDICARE: PAMELA SMITH MCMHC
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 Counselor
2101YA0400XAddiction (Substance Use Disorder) Counselor1174NH

General Provider Information

NPI Number : 1457486730
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA SMITH MCMHC
Provider Business Mailing Address
First Line : 140 QUEEN CITY AVE
Second Line :
City : MANCHESTER
State : NH
Zip : 03103-7122
Country : US
Telephone Number : 603-622-3020
Fax Number :
Provider Business Practice Location Address
First Line : 140 QUEEN CITY AVE
Second Line :
City : MANCHESTER
State : NH
Zip : 03103-7122
Country : US
Telephone Number : 603-622-3020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 08/23/2021

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Directions to “ PAMELA SMITH MCMHC” Practice Location

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