Provider Demographics
NPI:1447561329
Name:BHAT, SMITHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SMITHA
Middle Name:
Last Name:BHAT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 LACROSSE LN STE 109
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8521
Mailing Address - Country:US
Mailing Address - Phone:630-699-2589
Mailing Address - Fax:
Practice Address - Street 1:3380 LACROSSE LN STE 109
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8521
Practice Address - Country:US
Practice Address - Phone:630-699-2589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009556103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical