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NPI Code Detail

MEDICARE: MARK SMITH

MEDICARE: MARK SMITH
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1740789601
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK SMITH
Provider Business Mailing Address
First Line : 4851 INDEPENDENCE ST STE 200
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6712
Country : US
Telephone Number : 303-425-0300
Fax Number :
Provider Business Practice Location Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2018
Last Update Date : 01/29/2026

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Directions to “ MARK SMITH ” Practice Location

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