| Wm. Michael Smith, Ph.d, Llc | |
|
2919 17th Avenue #210 Longmont CO 80503 | |
| (303) 651-9290 | |
| (303) 651-7158 |
| Full Name | Wm. Michael Smith, Ph.d, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2919 17th Avenue, Longmont, Colorado |
| Authorized Official Name and Position | William Michael Smith (OWNER) |
| Authorized Official Contact | 3036519290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wm. Michael Smith, Ph.d, Llc 2727 Nelson Rd P-103 Longmont CO 80503 Ph: (303) 651-9290 | Wm. Michael Smith, Ph.d, Llc 2919 17th Avenue #210 Longmont CO 80503 Ph: (303) 651-9290 |
| NPI Number | 1184860348 |
|---|---|
| Provider Enumeration Date | 12/18/2008 |
| Last Update Date | 08/11/2010 |
| Medicare PECOS PAC ID | 7214089077 |
|---|---|
| Medicare Enrollment ID | O20100809000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184860348 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | C-2110 (Colorado) | Primary |
| Provider Name | William M Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518906361 PECOS PAC ID: 6305827841 Enrollment ID: I20040528001037 |
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