Doctor Name: | MR. MICHAEL SMITH |
NPI Number: | 1023224417 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC, CRC |
License Number: | 002312 |
Business Practice Address: | 2 Constitution Ct Unit 101 Hoboken, NJ - 070305588 |
Business Phone Number: | 2016535714 |
Business Fax Number: | 2129478135 |
Mailing Address: | 2 Constitution Ct, Unit 101 HOBOKEN |
State: | NJ |
Postal Code: | 070305588 |
Phone Number: | 2016535714 |
Fax Number: | 2129471471 |
NPI Enumeration Date: | 05/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 002312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |