Smith Psychotherapy Associates, S.c. | |
500 Lake Cook Rd Ste 350 Deerfield IL 60015-5268 | |
(847) 363-5845 | |
Not Available |
Full Name | Smith Psychotherapy Associates, S.c. |
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Speciality | Social Worker |
Location | 500 Lake Cook Rd Ste 350, Deerfield, Illinois |
Authorized Official Name and Position | Robert Joel Smith (OWNER) |
Authorized Official Contact | 8478248366 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Smith Psychotherapy Associates, S.c. 419 Lauren Ln Buffalo Grove IL 60089-3519 Ph: (847) 363-5845 | Smith Psychotherapy Associates, S.c. 500 Lake Cook Rd Ste 350 Deerfield IL 60015-5268 Ph: (847) 363-5845 |
NPI Number | 1609298702 |
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Provider Enumeration Date | 01/09/2014 |
Last Update Date | 08/24/2022 |
Certification Date | 08/24/2022 |
Medicare PECOS PAC ID | 6002047909 |
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Medicare Enrollment ID | O20140318000212 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609298702 | NPI | - | NPPES |
1114926235 | Other | IL | NPI TYPE I |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | 149000032 (Illinois) | Primary |
Provider Name | Robert J Smith |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114926235 PECOS PAC ID: 1355497637 Enrollment ID: I20090929000379 |
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