Provider Demographics
NPI:1457457053
Name:SMOOT, RICHARD LEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:SMOOT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6214 INTERBAY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-4907
Mailing Address - Country:US
Mailing Address - Phone:813-832-3267
Mailing Address - Fax:
Practice Address - Street 1:50 HOSPITAL DR STE 5A
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5247
Practice Address - Country:US
Practice Address - Phone:828-684-1115
Practice Address - Fax:828-687-6064
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7202103TC0700X
NC4158103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical