Ebony A Smith

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CAAC.CQ.70038578 Issued in WA

Practice address

1101 Andover Park W Ste 107
Tukwila, WA 98188-3911

Phone

(253) 890-7384

NPI assigned

Nov 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1356050058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 ANDOVER PARK W STE 107",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883911",
            "telephone_number": "253-890-7384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 ANDOVER PARK W STE 107",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883911",
            "telephone_number": "253-890-7384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 W Gowe St",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980325892",
            "country_code": "US",
            "telephone_number": "253-833-7444",
            "fax_number": "253-661-8631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EBONY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CAAC.CQ.70038578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2238126",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Smart
• Anisha L Smith
• Ashley Michelle Smith
• Blaise Kenneth Smith
• Bruce Cameron Smith, M.D.
• Lauren Ashley Smith
• Matthew Smith
• McKina Smith
• Shade Smith
• Tyler Smith, PHARMD

• Counselor in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.