Provider Demographics
NPI:1629345749
Name:SMITH, RICHARD B (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:B
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1111
Mailing Address - Country:US
Mailing Address - Phone:202-234-6227
Mailing Address - Fax:202-234-7898
Practice Address - Street 1:1555 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1111
Practice Address - Country:US
Practice Address - Phone:202-234-6227
Practice Address - Fax:202-234-7898
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1917103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist