Smith, Maurice Bradley

Smith, Maurice Bradley is an sole proprietor health care provider with primary practice located at 1935 County Road B2 W Ste 270 , Roseville MN 55113-2785. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Smith, Maurice Bradley can be contacted via phone (651) 481-0664.

Contact Information

Primary practice address
1935 County Road B2 W Ste 270 Roseville MN 55113-2785
Phone: (651) 481-0664
Fax: (651) 846-5877
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP0783 Minnesota
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X LP0783 Minnesota

Profile Details

NPI number 1467547257
LBN Legal business name Smith, Maurice Bradley
Credentials PH.D.,L.P.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2006
Last updated Feb 6th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467547257 NPPES
Minnesota Other HP21325 HEALTH PARTNERS INSURANCE
Minnesota Other 27F90SM HEALTH PARTNERS INSURANCE
Minnesota Other 6150656 HEALTH PARTNERS INSURANCE
Minnesota Other 680016304 HEALTH PARTNERS INSURANCE
Minnesota MEDICAID 092353200 HEALTH PARTNERS INSURANCE

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