Provider Demographics
NPI:1548808843
Name:PHELPS-SMITH LLC
Entity type:Organization
Organization Name:PHELPS-SMITH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PHELPS-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-329-7307
Mailing Address - Street 1:PO BOX 3235
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-3235
Mailing Address - Country:US
Mailing Address - Phone:413-329-7307
Mailing Address - Fax:
Practice Address - Street 1:2 HERIE AVE APT 2
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5548
Practice Address - Country:US
Practice Address - Phone:413-329-7307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health