Deondra Smith, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05785 Issued in MD

Practice address

836 Ritchie Hwy Ste 12F
Severna Park, MD 21146-4133

Phone

(410) 670-9048

Fax

(410) 835-9612

NPI assigned

Feb 17, 2018

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

Other names 1

• Deondra Jacobs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Breakthrough Therapeutic Concepts, LLC.

  • Clinical Psychologist
  • Severna Park, MD
  • NPI 1336769561
  NPD Authorized official

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

{
    "created_epoch": "1518825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1063912921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 RITCHIE HWY STE 12F",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464133",
            "telephone_number": "410-670-9048",
            "fax_number": "410-835-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 RITCHIE HWY STE 12F",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464133",
            "telephone_number": "410-670-9048",
            "fax_number": "410-835-9612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Gambrills Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Gambrills",
            "state": "MD",
            "postal_code": "210541102",
            "country_code": "US",
            "telephone_number": "443-917-3534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DEONDRA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-17",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEONDRA",
            "last_name": "JACOBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Albert Peter Sindall Jr., D.D.S.
• Morgan Sirota, BEHAVIOR TECHNICIAN
• Annamarie Skinker, SLP
• Emily Slinko, MS/OTR/L
• Marissa Britt Small, COTA/L
• Jessica Smith
• Kirstin Smith, PTA
• Patrice Alexis Smith
• Raeshelle Smith, BS
• Tammi Smith

• Clinical Psychologist in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.