MEDICARE: DR. PAUL STEVEN SMITH PH.D.

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	103TF0000X	Family Psychologist	20040450A	IN
2	103TP2701X	Group Psychotherapy Psychologist	20040450A	IN
3	103TB0200X	Cognitive & Behavioral Psychologist	20040450A	IN
4	103TC0700X	Clinical Psychologist	20040450A	IN
5	103TC1900X	Counseling Psychologist	20040450A	IN
6	103TC2200X	Clinical Child & Adolescent Psychologist	20040450A	IN
7	103TS0200X	School Psychologist	20040450A	IN
8	103T00000X	Psychologist	20040450A	IN

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	:	1851300354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL STEVEN SMITH PH.D.

Provider Business Mailing Address
First Line	:	1515 N POST RD STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4213
Country	:	US
Telephone Number	:	317-282-3088
Fax Number	:	317-295-3555

Provider Business Practice Location Address
First Line	:	1515 N POST RD STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4213
Country	:	US
Telephone Number	:	317-282-3088
Fax Number	:

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	05/31/2024

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