Selena P Smith, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3926 Issued in PR

Practice address

400 W Fort St.
CRH 2ND Floor
Boise, ID 83702-4501

Phone

(208) 422-1018

NPI assigned

Dec 8, 2011

Last updated

Aug 14, 2024By the provider in NPPES

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

Other names 1

• Selena Pinero-Abramovich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1194093963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W FORT ST.",
            "address_2": "CRH 2ND FLOOR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-422-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W FORT ST.",
            "address_2": "CRH 2ND FLOOR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-422-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SELENA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "3926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELENA",
            "last_name": "PINERO-ABRAMOVICH",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rusty Smith, PSYD
• Samantha Jo Smith, PA-C
• Samuel G. Smith, D.M.D.,M.S.
• Sara Jean Smith, NP-BC
• Scott Smith, MD
• Stephanie Ann Smith, MSW, LCSW
• Stephen C Smith, MD
• Tammy Lynn Smith, DO
• Tara Lynn Hendrickson Smith, LCSW
• Taylor Michael Smith, PHARMD

• Clinical Psychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.