Provider Demographics
NPI:1427879964
Name:MJ SMART COUNSELING PLLC
Entity type:Organization
Organization Name:MJ SMART COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:SMART
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LAC
Authorized Official - Phone:631-555-9311
Mailing Address - Street 1:11431 CLARKSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-2114
Mailing Address - Country:US
Mailing Address - Phone:631-579-9311
Mailing Address - Fax:
Practice Address - Street 1:11431 CLARKSON ST
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-2114
Practice Address - Country:US
Practice Address - Phone:631-579-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health