Shontell Smith

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

39793 Issued in TX

Practice address

810 W 45TH St
Austin, TX 78751-2802

Phone

(512) 451-2242

NPI assigned

Apr 12, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Austin Child Guidance Center

  • Community/Behavioral Health Agency
  • Austin, TX
  • NPI 1912054776
  NPD (past)

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1407436645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W 45TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512802",
            "telephone_number": "512-451-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W 45TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512802",
            "telephone_number": "512-451-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHONTELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "39793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Smith, LCSW
• Saylor Smith
• Scott Smith, LCSW, PHD
• Shakira Smith
• Shelley Dianne Smith, LPC
• Sierra Smith, L.AC
• Stephen Reilly Smith, MD
• Steven Smith, LCDC
• Steven Craig Smith, LCSW
• Sue Smith

• Clinical Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.