Provider Demographics
NPI:1841502424
Name:SMITH, RICHARD M (BS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
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Mailing Address - Street 1:9545 QUAIL RIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7538
Mailing Address - Country:US
Mailing Address - Phone:810-343-0798
Mailing Address - Fax:248-543-0017
Practice Address - Street 1:2710 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1630
Practice Address - Country:US
Practice Address - Phone:248-543-1090
Practice Address - Fax:248-543-0017
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)