Sandra Dale Smith

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

523 Dixie St Ste 1
Carrollton, GA 30117-3870

Phone

(770) 456-3266

NPI assigned

Aug 2, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1154095495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 NORTHLAKE DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310931646",
            "telephone_number": "478-952-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 DIXIE ST STE 1",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173870",
            "telephone_number": "770-456-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SANDRA",
        "middle_name": "DALE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tanner.org",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "523 Dixie St Ste 1",
            "city": "Carrollton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301173870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Makenzie Smith
• Maria A. Smith, NP
• Mary W Smith, HADS
• Rebecca Smith, P.T.
• Ryan Smith, ATC LAT
• Stuart Smith, PA-C
• Tayha Genet Smith
• Taylor Ann Smith
• Somatic Physical Therapy LLC
• Southern Family Markets LLC

• Counselor in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.