MEDICARE: ALEXYS 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
1	101Y00000X	Counselor	37AC00851000	NJ

General Provider Information

NPI Number	:	1811862766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXYS SMITH

Provider Business Mailing Address
First Line	:	1234 ORANGE AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5230
Country	:	US
Telephone Number	:	973-981-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 PARK ST STE 104
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2988
Country	:	US
Telephone Number	:	973-891-0793
Fax Number	:

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

Provider Enumeration Date	:	10/09/2025
Last Update Date	:	10/09/2025

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Directions to “ ALEXYS SMITH ” Practice Location

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