Susan Smith

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-63689 Issued in FL

Practice address

247 SW Port St Lucie Blvd
Port St Lucie, FL 34984-5015

Phone

(772) 207-1356

NPI assigned

Jun 7, 2018

Last updated

Jan 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1033602784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 SE ASTER LN APT 1305",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349945728",
            "telephone_number": "813-748-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 SW PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349845015",
            "telephone_number": "772-207-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-23-63689",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda A Smith, L.C.S.W.
• Malik Smith
• Mara Smith, RD, LDN
• Martina Smith
• Merlene Smith
• Tiana Smith
• SMR Medical Corp
• SNH Fla Tenant LLC (The Palms of St. Lucie West)
• SNH SE Tenant TRS, Inc (The Gardens of Port St. Lucie)
• SNH SE Tenant TRS, Inc (The Gardens of Port St. Lucie)

• Behavior Analyst in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.