Provider Demographics
NPI:1700136918
Name:SMITH, MARIA (CCTS,CGLC)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:CCTS,CGLC
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:ROVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CGLC
Mailing Address - Street 1:461 COCHRAN RD
Mailing Address - Street 2:#140
Mailing Address - City:MT LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1253
Mailing Address - Country:US
Mailing Address - Phone:412-969-2733
Mailing Address - Fax:412-774-2069
Practice Address - Street 1:210 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:MT LEBANON
Practice Address - State:PA
Practice Address - Zip Code:15228-1419
Practice Address - Country:US
Practice Address - Phone:412-969-2733
Practice Address - Fax:412-774-2069
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 172V00000X, 174400000X, 171M00000X, 174H00000X, 246Z00000X
PAPA-2279225CA2400X, 225CA2500X
VAPA-2279225CA2400X, 225CA2500X
WVPA-2279225CA2400X, 225CA2500X
OHPA-2279225CA2400X, 225CA2500X
MDPA-2279225CA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No172V00000XOther Service ProvidersCommunity Health Worker
No174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVPA-2279(A)OtherCOGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC
PAPA-2279(A)OtherCOGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC
OHPA-2279(A)OtherCOGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC
1082811775OtherGLC CERTIFICATION BY SPENCER INSTITUTE(GREEN LIVING)
MDPA-2279(A)OtherCOGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC
VAPA-2279(A)OtherCOGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC