Provider Demographics
NPI:1518198845
Name:NAPLES PSYCHOLOGICAL LLC
Entity Type:Organization
Organization Name:NAPLES PSYCHOLOGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:239-592-1809
Mailing Address - Street 1:2180 IMMOKALEE RD
Mailing Address - Street 2:SUITE216
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1421
Mailing Address - Country:US
Mailing Address - Phone:239-591-1809
Mailing Address - Fax:239-596-8901
Practice Address - Street 1:2180 IMMOKALEE RD
Practice Address - Street 2:SUITE216
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1421
Practice Address - Country:US
Practice Address - Phone:239-591-1809
Practice Address - Fax:239-596-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty