| Doctor Name: | MR. PATRICK SMITH |
| NPI Number: | 1255696787 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS, LPC |
| License Number: | PC005736 |
| Business Practice Address: | 480 Norristown Rd Blue Bell, PA - 194222334 |
| Business Phone Number: | 6105640463 |
| Business Fax Number: | |
| Mailing Address: | 47 W 6th St, Second Floor BRIDGEPORT |
| State: | PA |
| Postal Code: | 194051107 |
| Phone Number: | 6105640463 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2012 |
| NPI Last Update Date: | 07/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC005736 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |