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Organization
SMITH BEHAVIORAL HEALTH, P.C.
Active
Organization
SMITH BEHAVIORAL HEALTH, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK IVAN SMITH (PRESIDENT)
(602) 743-8157
Entity
Organization
Contact information
Practice address
225 W 1ST ST UNIT 120, MESA, AZ 85201-6554
(602) 743-8157
Mailing address
225 W 1ST ST UNIT 120, MESA, AZ 85201-6554
(602) 743-8157
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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