Provider Demographics
NPI:1780807669
Name:SMITH, NORMAN JOSEPH (CASAC)
Entity type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:JOSEPH
Last Name:SMITH
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 LIVINGSTON AVE APT C-6
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12207-2320
Mailing Address - Country:US
Mailing Address - Phone:517-462-9224
Mailing Address - Fax:
Practice Address - Street 1:123 LIVINGSTON AVE APT C-6
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-2320
Practice Address - Country:US
Practice Address - Phone:517-462-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16677101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)