MEDICARE: DR. CARRIE D SMITH PSY.D.

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	103T00000X	Psychologist	PS016889	PA

General Provider Information

NPI Number	:	1528217809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARRIE D SMITH PSY.D.

Provider Business Mailing Address
First Line	:	200 N 7TH ST
Second Line	:	LEBANON VA MEDICAL CENTER
City	:	LEBANON
State	:	PA
Zip	:	17046-5040
Country	:	US
Telephone Number	:	717-272-6621
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 N 7TH ST
Second Line	:	LEBANON VA MEDICAL CENTER
City	:	LEBANON
State	:	PA
Zip	:	17046-5040
Country	:	US
Telephone Number	:	717-272-6621
Fax Number	:

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

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	08/13/2014

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