Provider Demographics
NPI:1215031786
Name:SMYTH COUNTY PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:SMYTH COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BLEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-783-3791
Mailing Address - Street 1:121 BAGLEY CIRCLE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354
Mailing Address - Country:US
Mailing Address - Phone:276-783-3791
Mailing Address - Fax:276-783-3291
Practice Address - Street 1:121 BAGLEY CIR
Practice Address - Street 2:SUITE 300
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-3140
Practice Address - Country:US
Practice Address - Phone:276-783-3791
Practice Address - Fax:276-783-3291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1215031786251300000X
VA251300000X251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004979095Medicaid