Charles Elmore Smith

Individual provider Active NPI Mental Health Counselor · Springfield, MA

NPI 1649630633 · NPPES record last updated Mar 3, 2016

Key facts

NPI
1649630633
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
28 Dalton PL
Springfield, MA 01109-1611
Phone
(413) 885-0416
NPI assigned
Mar 3, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
The Men of Honor Youth Mentorship Program Inc. Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

28 Dalton PL
Springfield, MA 01109-1611

Mailing address

28 Dalton PL
Springfield, MA 01109-1611
Phone (413) 885-0416

Other providers in Springfield, MA

All providers in Springfield, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.