Provider Demographics
NPI:1366966749
Name:SMITH, JOSEPH DON III
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DON
Last Name:SMITH
Suffix:III
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 1:6944 PUETOLLANO DR
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2339
Mailing Address - Country:US
Mailing Address - Phone:702-786-9817
Mailing Address - Fax:
Practice Address - Street 1:2713 MAGNET ST
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5433
Practice Address - Country:US
Practice Address - Phone:702-750-0839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health