Active NPI
Stephen J. Smith, PSY.D.
- Clinical Psychologist
- Burbank, CA
National Provider Identifier
1043532088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY22832
- Practice address
- 2600 West Olive Avenue
5TH Floor
Burbank, CA 91505 - Phone
- (818) 391-9140
- NPI assigned
- Feb 18, 2010
- Last updated
- May 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 22832 | CA | |
| Adult Development & Aging Psychologist | 103TA0700X | 22832 | CA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 22832 | CA | |
| Clinical Psychologist | 103TC0700X | 22832 | CA | |
| Clinical Psychologist | 103TC0700X | PSY22832 | CA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 22832 | CA | |
| Group Psychotherapy Psychologist | 103TP2701X | 22832 | CA | |
| Behavior Analyst | 103K00000X | 22832 | CA |
Addresses
Primary practice location
2600 West Olive Avenue
5TH Floor
Burbank, CA 91505
Mailing address
2600 West Olive Avenue
5TH Floor
Burbank, CA 91505
Phone (818) 391-9140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY22832 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pure Autism Counseling Center Inc | Current | Accepting new patients | |
| Stephen J. Smith | Past | Accepting new patients |
Locations
17702 Sierra Hwy
Santa Clarita, CA 91351
Phone (888) 770-5222
19981 Soledad Canyon Rd
Santa Clarita, CA 91351
Phone (661) 360-7730
Interoperability endpoints
- https://api.platform.athenahealth.com/19641/brand/1/csg/1/fhir/r4
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Pacc Mental Health Services
- Community/Behavioral Health Agency
- Santa Clarita, CA
- NPI 1649737735
-
- Community/Behavioral Health Agency
- Burbank, CA
- NPI 1730570888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1043532088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 WEST OLIVE AVENUE",
"address_2": "5TH FLOOR",
"city": "BURBANK",
"state": "CA",
"postal_code": "91505",
"telephone_number": "818-391-9140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 WEST OLIVE AVENUE",
"address_2": "5TH FLOOR",
"city": "BURBANK",
"state": "CA",
"postal_code": "91505",
"telephone_number": "818-391-9140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "STEPHEN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-18",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "22832",
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "CA",
"license": "22832",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "22832",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "22832",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY22832",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "22832",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "CA",
"license": "22832",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "22832",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.