Dr. Michael David Smith
Psychologist Clinical Psychologist
1836 South Ave
La Crosse
, Wisconsin 54601-5429
Dr. Michael David Smith
Psychologist Clinical Psychologist
1836 South Ave
La Crosse
, Wisconsin 54601-5429
(608) 782-7300
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About
Features
Specialties
- Psychologist
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Michael David Smith
- 1836 South Ave
- La Crosse, WI
- Zip : 54601-5429
- Phone : (608) 782-7300
Second Address
- Dr. Michael David Smith
- 1836 South Ave
- La Crosse, WI
- Zip : 54601-5429
- Phone : (608) 782-7300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 102L00000X | Psychologist | 3168 | WI |
| Y | 103T00000X | Psychologist | 3168 | WI |
| N | 103G00000X | Clinical Psychologist | PS015414 | PA |
| N | 103TC0700X | Clinical Psychologist | PS015414 | PA |
National Provider Identifier
| NPI | 1003167909 |
|---|---|
| Provider Name | Dr. Michael David Smith |
| First Address | La Crosse, WI 54601-5429 |
| Second Address | La Crosse, WI 54601-5429 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/10/2012 |
| Last Update Date | 09/07/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.