Stacey Smith, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4584 Issued in AZ

Practice address

2211 S Mill Ave
Tempe, AZ 85282-2115

Phone

(214) 280-6446

NPI assigned

Mar 8, 2016

Last updated

Feb 7, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1184085813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W GROVE PKWY APT 2027",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852834526",
            "telephone_number": "214-280-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 S MILL AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822115",
            "telephone_number": "214-280-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STACEY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-08",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "4584",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Teresa Smith, LCSW
• Melissa A Smith, CCC SLP
• Michael G Smith, DMD
• Nathan David Smith
• Scott Smith, MSW
• Stacy L Smith, MBA, MA, BCBA
• Tavianna Smith, RBT
• Todd Alan Smith, MD
• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Smiths Food & Drug Centers Inc (Frys Food and Drug)

• Psychologist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.