Individual
MICHAEL DORIAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1241 MALL DR, RICHMOND, VA 23235-4737
(804) 794-8828
Mailing address
1241 MALL DRIVE, RICHMOND, VA 23235-4737
(804) 794-8828
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701000583
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005407036
—
VA
01
—
082305
ANTHEM BCBS OF VIRGINIA
VA
01
—
084256
SENTARA
VA
01
—
87647
CIGNA
MN
Enumeration date
05/23/2006
Last updated
04/17/2019
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