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:
Health care specialties
Specialty | Code | License # | 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 5 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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