Malloree Jne Smith, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2158 Issued in KS

Practice address

225 Bennett Ave
1St Special Operations Support Squadron
Hurlburt Field, FL 32544

Phone

(850) 420-4281

NPI assigned

Sep 20, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southwest Guidance Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Liberal, KS
  • NPI 1154421097
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1023444171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BENNETT AVE",
            "address_2": "1ST SPECIAL OPERATIONS SUPPORT SQUADRON",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-420-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BENNETT AVE",
            "address_2": "1ST SPECIAL OPERATIONS SUPPORT SQUADRON",
            "city": "HURLBURT FIELD",
            "state": "FL",
            "postal_code": "32544",
            "telephone_number": "850-420-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MALLOREE",
        "middle_name": "JNE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Abraham Shwalb, PHD
• Maureen E. Simmons, LCSW
• Shirley Johnson Sims, LCSW
• Alexandra Campbell Smith, LICSW (MA, LCSW (FL)
• Jeffrey James Smith, LCSW, DSW, BCD
• Sarah Frances Smith, MPT, OCS
• Gemma I Sohn, LCSW-C
• Tatiana Margarita Soria, PSY.D.
• Jonathan James Sparks
• Sinead Catherine Specht

• Clinical Psychologist in Hurlburt Field, FL
• Providers in Hurlburt Field, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.