Provider Demographics
NPI:1528439957
Name:SMITH, STEVEN M (MA, LMFT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 E PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PORT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93041-2636
Mailing Address - Country:US
Mailing Address - Phone:805-291-1629
Mailing Address - Fax:
Practice Address - Street 1:560 E PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93041-2636
Practice Address - Country:US
Practice Address - Phone:805-291-1629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF93146106H00000X
172V00000X
CALMFT124809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker