MEDICARE: NICOLE 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		CA

General Provider Information

NPI Number	:	1831022318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE SMITH

Provider Business Mailing Address
First Line	:	31761 VILLAGE SCHOOL RD
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4502
Country	:	US
Telephone Number	:	818-889-1450
Fax Number	:

Provider Business Practice Location Address
First Line	:	31761 VILLAGE SCHOOL RD
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4502
Country	:	US
Telephone Number	:	818-889-1450
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ NICOLE SMITH ” Practice Location

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