Walter James Smith, MA, LCPC, NCC

Individual provider Active NPI Professional Counselor · Red Lodge, MT

NPI 1013037464 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1013037464
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LCPC 40 (MT)
Practice address
4 Harnish Lane
Red Lodge, MT 59068-1992
Phone
(406) 671-6289
Fax
(406) 446-2114
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LCPC 40MTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LCPC 40 MT Yes

Addresses

Primary practice location

4 Harnish Lane
Red Lodge, MT 59068-1992

Mailing address

PO Box 1992
Red Lodge, MT 59068-1992
Phone (406) 672-6289

Other identifiers

IdentifierTypeStateIssuer
0252297MedicaidMT
07547-0OtherMTMT BLUECROSS BLUESHIELD

Other names

  • Mr. W. James Smith Professional name

Other providers in Red Lodge, MT

All providers in Red Lodge, MT · Professional Counselor in Montana

Sources for this page

Verify at the official NPI Registry.