Provider Demographics
NPI:1194103549
Name:SMITH, ADAM
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 CHERRY CREEK DRIVE SOUTH
Mailing Address - Street 2:SUITE 940
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246
Mailing Address - Country:US
Mailing Address - Phone:303-322-7108
Mailing Address - Fax:303-322-9989
Practice Address - Street 1:4500 CHERRY CREEK DRIVE SOUTH
Practice Address - Street 2:SUITE 940
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-322-7108
Practice Address - Fax:303-322-9989
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst