Bernadette Evans-Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

9262 Issued in FL

Practice address

11000 Prosperity Farms Rd Ste 200
Palm Beach Gardens, FL 33410-3470

Phone

(561) 558-4161

NPI assigned

Jan 29, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1265670202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 PROSPERITY FARMS RD STE 200",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103470",
            "telephone_number": "561-558-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 PROSPERITY FARMS RD STE 200",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103470",
            "telephone_number": "561-558-4161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4711 Golf Rd",
            "address_2": "Suite 1100",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600761224",
            "country_code": "US",
            "telephone_number": "847-933-9339",
            "fax_number": "847-933-0874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS-SMITH",
        "first_name": "BERNADETTE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "15988",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007549",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "9262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily N Etheridge
• Keslene Fabienne Etienne
• Marie Mylene Etienne, DNP, FNP
• Kerlande Eugene, APRN, FNP-BC
• Johanna Eugenio
• Bonnie Evans
• Katia Sanchez Evans, MMS, PA-C
• Danielle Marie Evelyn
• Victor Evins
• Maya Ashley Ewan

• Clinical Psychologist in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.