Jaclyn J Smith

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61227019 Issued in WA

Practice address

6005 Tyee Dr SW
Tumwater, WA 98512-7356

Phone

(360) 464-6867

NPI assigned

Oct 25, 2021

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1053075242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 COMMERCIAL ST",
            "city": "RAYMOND",
            "state": "WA",
            "postal_code": "98577",
            "telephone_number": "503-791-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 TYEE DR SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127356",
            "telephone_number": "360-464-6867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1013 Commercial St",
            "address_purpose": "LOCATION",
            "city": "Raymond",
            "state": "WA",
            "postal_code": "98577",
            "country_code": "US",
            "telephone_number": "360-942-3415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACLYN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61227019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Robert Smith, D.C.
• Calen Christine Smith, LMHC
• Concepcion Smith
• Cynthia Smith
• Edwina Smith, LMT
• Karlin Kay Smith, LMT
• Loraine B Smith, RN
• Lynnette Smith, SLPA
• Murray L Smith, DC
• Tiffany Ann Smith

• Addiction (Substance Use Disorder) Counselor in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.