Keiquanae Tatayana Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

55 Sergeant Prentiss Dr Ste 102
Natchez, MS 39120-4791

Phone

(601) 304-5567

Fax

(601) 304-5697

NPI assigned

Feb 23, 2019

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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.

• Bruce Professional Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Harahan, LA
  • NPI 1477956126
  NPD (past)

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

{
    "created_epoch": "1550880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550880000000",
    "number": "1043777345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SERGEANT PRENTISS DR STE 102",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204791",
            "telephone_number": "601-304-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SERGEANT PRENTISS DR STE 102",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204791",
            "telephone_number": "601-304-5567",
            "fax_number": "601-304-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEIQUANAE",
        "middle_name": "TATAYANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-23",
        "last_updated": "2019-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Easterling Smith, MD
• Brittany Scroggins Smith
• Erica F Smith, FNP-C
• Harry Smith
• Katie Smith, M.S.,CCC-SLP
• Lloyd Douglas Smith, M.D.
• Monica A Smith
• Paul Eugene Smith, CRNA
• Tracy Lynette Smith
• Valenthia Smith

• All providers in Natchez, MS
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2019; 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.