Smith, Peter Norman
Smith, Peter Norman is an sole proprietor health care provider with primary practice located at 101 Livingston Loop Ste 1 , Santa Teresa NM 88008-9753. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Prescribing (Medical). Behavioral Health & Social Service Providers / Prescribing (Medical) is his primary health care specialty. Smith, Peter Norman can be contacted via phone (505) 506-2546.Contact Information
Primary practice address
101 Livingston Loop Ste 1
Santa Teresa NM 88008-9753
Phone: (505) 506-2546
Fax: (575) 201-7070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1290 | New Mexico |
| Behavioral Health & Social Service Providers / Prescribing (Medical) | 103TP0016X | 0039C | New Mexico |
| Behavioral Health & Social Service Providers / Prescribing (Medical) | 103TP0016X | PSY-RXP0053 | New Mexico |
Profile Details
| NPI number | 1508061169 |
|---|---|
| LBN Legal business name | Smith, Peter Norman |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2007 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1508061169 | NPPES |
| Arizona | Other | 4320 | BCIA-C |
| Arizona | Other | 612352100 | BCIA-C |
| Arizona | MEDICAID | 22639560 | BCIA-C |
| Arizona | Other | E-1463 | BCIA-C |
| Arizona | Other | 1290 | BCIA-C |
| Arizona | Other | PSY-RXP0053 | BCIA-C |
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