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Provider Information for 1891352761


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ERIC N SMITH LSW, MSW


Sex: Male

NPI: 1891352761
Last Updated: 2022-08-16
Certification Date: 2022-08-16

Details

NameValue
NPI1891352761
Enumeration Date2019-05-24
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 4856 INNOVATION DR STE B
FORT COLLINS, CO 80525-5540
United States

Phone: 970-494-4200 | Fax:970-613-4475
 
Primary Practice Address 1250 N WILSON AVE
LOVELAND, CO 80537-4461
United States

Phone: 970-494-4200 | Fax:970-613-4475
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 104100000X - Social Worker COLSW.0009922956
Yes 1041C0700X - Social Worker - ClinicalCOCSW.09928510