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NPI Code Detail

MEDICARE: AMY SMART

MEDICARE: AMY SMART
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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.130750OH

General Provider Information

NPI Number : 1609388255
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY SMART
Provider Business Mailing Address
First Line : 48 PRIVATE DRIVE 339
Second Line :
City : SOUTH POINT
State : OH
Zip : 45680-8919
Country : US
Telephone Number : 740-451-1455
Fax Number :
Provider Business Practice Location Address
First Line : 48 PRIVATE DRIVE 339
Second Line :
City : SOUTH POINT
State : OH
Zip : 45680-8919
Country : US
Telephone Number : 740-451-1455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2017
Last Update Date : 04/10/2018

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Directions to “ AMY SMART ” Practice Location

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