| Dr Heather Smith Llc | |
|
12021 Pennsylvania St Ste 205 Thornton CO 80241-3152 | |
| (720) 263-1185 | |
| (720) 263-2817 |
| Full Name | Dr Heather Smith Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 12021 Pennsylvania St Ste 205, Thornton, Colorado |
| Authorized Official Name and Position | Heather Anne Smith (OWNER) |
| Authorized Official Contact | 7202631185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Heather Smith Llc 12021 Pennsylvania St Ste 205 Thornton CO 80241-3152 Ph: (720) 263-1185 | Dr Heather Smith Llc 12021 Pennsylvania St Ste 205 Thornton CO 80241-3152 Ph: (720) 263-1185 |
| NPI Number | 1235520669 |
|---|---|
| Provider Enumeration Date | 02/06/2015 |
| Last Update Date | 03/12/2021 |
| Certification Date | 09/28/2020 |
| Medicare PECOS PAC ID | 8921324732 |
|---|---|
| Medicare Enrollment ID | O20150312002489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235520669 | NPI | - | NPPES |
| 31306551 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 3984 (Colorado) | Primary |
| Provider Name | Heather A Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669742235 PECOS PAC ID: 9830415645 Enrollment ID: I20180508000391 |
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