MEDICARE: STEPHEN MICHAEL SMITH LMHC

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	MH 4604	FL

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	:	1649510173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN MICHAEL SMITH LMHC

Provider Business Mailing Address
First Line	:	5029 NORTH LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-2088
Country	:	US
Telephone Number	:	407-522-2260
Fax Number	:	407-522-2272

Provider Business Practice Location Address
First Line	:	5029 NORTH LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-2088
Country	:	US
Telephone Number	:	407-522-2260
Fax Number	:	407-522-2272

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

Provider Enumeration Date	:	02/20/2013
Last Update Date	:	02/20/2013

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