Smith, Mandy
Smith, Mandy is an sole proprietor health care provider with primary practice located at 405 Allegheny Ave , Towson MD 21204-4256. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Smith, Mandy can be contacted via phone (443) 470-5656.Contact Information
Primary practice address
405 Allegheny Ave
Towson MD 21204-4256
Phone: (443) 470-5656
Fax: (443) 470-8658
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | LC1909 | Maryland |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LC1909 | Maryland |
Profile Details
| NPI number | 1710323886 |
|---|---|
| LBN Legal business name | Smith, Mandy |
| Credentials | LCPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 16th, 2013 |
| Last updated | Oct 17th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710323886 | NPPES |
| Maryland | MEDICAID | 645011300 |
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