Provider Demographics
NPI:1598124273
Name:SMITH, RICHARD (MS, LMFT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SMITH
Suffix:
Gender:
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 598 NARR AVENUE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85369
Mailing Address - Country:US
Mailing Address - Phone:928-269-2561
Mailing Address - Fax:
Practice Address - Street 1:BLDG 598 NARR AVENUNE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85369
Practice Address - Country:US
Practice Address - Phone:928-269-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16106106H00000X
AL193106H00000X
AZ10452106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist