Keisha Smith, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4757 Issued in NC

Practice address

1601 Brenner Ave
Salisbury, NC 28144-2515

Phone

(704) 638-9000

NPI assigned

Dec 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1043513716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9208 GRAHAM RIDGE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "704-638-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEISHA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-17",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Robert Smith, DDS
• Chanell N Smith
• David N Smith, MD
• Eric Smith, L.P.C.
• Katelyn Marie Smith, PHYSICIAN ASSISTANT
• Kimberly Renee Smith, PHARM.D.
• Madison Smith
• Mary Smith, PTA
• Nicole Yvette Smith, PHARM D
• Rebecca Janelle Smith, DO

• Clinical Psychologist in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.