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LEWIS SMITH PH.D., P.C.

Clinical Neuropsychologist

Troy, Michigan

Provider NPI: 1578514584

Organization Information:
Organization Name:  LEWIS SMITH PH.D., P.C.
Organization is not Subpart
Authorized Official:  LEWIS WILSON SMITH  LICENSED PSYCHOLOGIST  248-6442955

Practice Location:
1655 W BIG BEAVER RD  TROY, MI 48084 US
Tel: 248-644-2955  Fax: 248-644-0237

Business Mailing Address:
1655 W BIG BEAVER RD  TROY, MI 48084 US
Tel: 248-644-2955  Fax: 248-644-0237

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103T00000XBehavioral Health & Social Service Providers
Psychologist
MI6301002143
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MI6201002143

Other Provider Identifiers:

IssuerNumberStateType
LICENSED PSYCHOLOGIST6301002143MI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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