Provider Demographics
NPI:1811478647
Name:DAVIES SMITH, AMY (MA, LCMHC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DAVIES SMITH
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:165 S SUGAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEARE
Mailing Address - State:NH
Mailing Address - Zip Code:03281-6022
Mailing Address - Country:US
Mailing Address - Phone:603-340-7213
Mailing Address - Fax:
Practice Address - Street 1:165 S SUGAR HILL RD
Practice Address - Street 2:
Practice Address - City:WEARE
Practice Address - State:NH
Practice Address - Zip Code:03281-6022
Practice Address - Country:US
Practice Address - Phone:603-340-7213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2701OtherNH LCMHC LICENSE
NH3078870Medicaid