MEDICARE: SUZANNE M SMITH MA, LCSW

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	1041C0700X	Clinical Social Worker	1923	CO

General Provider Information

NPI Number	:	1932540374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE M SMITH MA, LCSW

Provider Business Mailing Address
First Line	:	16877 E FAIR PL
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-5014
Country	:	US
Telephone Number	:	303-475-2757
Fax Number	:	720-210-9814

Provider Business Practice Location Address
First Line	:	7600 E ARAPAHOE RD
Second Line	:	SUITE 305
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-1260
Country	:	US
Telephone Number	:	303-475-2757
Fax Number	:	720-210-9814

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

Provider Enumeration Date	:	07/15/2013
Last Update Date	:	07/15/2013

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