Provider Demographics
NPI:1235320003
Name:SMOCK & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SMOCK & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER/OFFICER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:SMOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-781-6690
Mailing Address - Street 1:134 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1737
Mailing Address - Country:US
Mailing Address - Phone:816-781-6690
Mailing Address - Fax:816-781-2897
Practice Address - Street 1:134 N WATER ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1737
Practice Address - Country:US
Practice Address - Phone:816-781-6690
Practice Address - Fax:816-781-2897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY00383103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty