Tanya Lake-Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4109 Enisa Way
McDonough, GA 30253-4337

Phone

(678) 886-3984

NPI assigned

Jan 5, 2026

Last updated

Jan 5, 2026By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SRC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1841686433
  Authorized official Same address or phone

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

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1356208284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 ENISA WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534337",
            "telephone_number": "678-886-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 ENISA WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534337",
            "telephone_number": "678-886-3984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE-SMITH",
        "first_name": "TANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kulani Spa & Wellness, LLC
• Sneha Kumar, O.D.
• Kevin Michael Kurey, MD
• Kortni La Grone
• Lake Dow Physical Therapy, Inc.
• Stephen Lam, O.D.
• Kiarha Lamar
• Karen Elizabeth Landry, LPC
• Kimberly Ann Lang-Kelly, PHARMD
• Daniel Lankford, NP

• Mental Health Counselor in McDonough, GA
• Providers in McDonough, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.