| Smith Psychological Services | |
|
1401 Airport Pkwy Ste 240 Cheyenne WY 82001-1542 | |
| (307) 632-7771 | |
| (307) 632-9697 |
| Full Name | Smith Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 1401 Airport Pkwy Ste 240, Cheyenne, Wyoming |
| Authorized Official Name and Position | Shaina Smith (OWNER/LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 3076327771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smith Psychological Services 1401 Airport Pkwy Ste 240 Cheyenne WY 82001-1542 Ph: (307) 632-7771 | Smith Psychological Services 1401 Airport Pkwy Ste 240 Cheyenne WY 82001-1542 Ph: (307) 632-7771 |
| NPI Number | 1578160966 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 01/08/2021 |
| Certification Date | 01/05/2021 |
| Medicare PECOS PAC ID | 2668885021 |
|---|---|
| Medicare Enrollment ID | O20210105000622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578160966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Secondary |
| Provider Name | Amy Nicole Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699229260 PECOS PAC ID: 4183961782 Enrollment ID: I20190118002753 |
| Provider Name | Shaina Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730731696 PECOS PAC ID: 4789911496 Enrollment ID: I20190802002105 |
| Provider Name | Monica Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164040101 PECOS PAC ID: 7810374006 Enrollment ID: I20220509001208 |
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