Provider Demographics
NPI:1508755737
Name:SMITH, GAGE MATTHEW
Entity type:Individual
Prefix:
First Name:GAGE
Middle Name:MATTHEW
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 RIVERWALK PL UNIT 342
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3658
Mailing Address - Country:US
Mailing Address - Phone:304-886-1675
Mailing Address - Fax:
Practice Address - Street 1:10 N JEFFERSON ST STE 202
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4865
Practice Address - Country:US
Practice Address - Phone:240-624-6428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health