Provider Demographics
NPI:1396982211
Name:SMITH, STOCKHAMMER AND ASSOCIATES, PLLC
Entity type:Organization
Organization Name:SMITH, STOCKHAMMER AND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-614-7600
Mailing Address - Street 1:6511 GLENRIDGE PARK PL
Mailing Address - Street 2:STE 5
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3452
Mailing Address - Country:US
Mailing Address - Phone:502-614-7600
Mailing Address - Fax:
Practice Address - Street 1:6511 GLENRIDGE PARK PL
Practice Address - Street 2:STE 5
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3452
Practice Address - Country:US
Practice Address - Phone:502-614-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty