Mack Stevenson Smith, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3744 W Chester Pike
Newtown Square, PA 19073-3224

Phone

(610) 863-7476

NPI assigned

Feb 3, 2023

Sex

Male

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

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1407552268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639561",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 W CHESTER PIKE",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733224",
            "telephone_number": "610-863-7476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1553 Chester Pike",
            "address_purpose": "LOCATION",
            "city": "Crum Lynne",
            "state": "PA",
            "postal_code": "190221022",
            "country_code": "US",
            "telephone_number": "610-864-7376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MACK",
        "middle_name": "STEVENSON",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hrant Siradarian
• Shinette Sirmans-McRae, M.D.
• Amber Smith, LCSW
• Chelsea Victoria Smith, MS, BCBA
• Lauren Elizabeth Smith, RDN
• Rebecca Ann Smith
• So Love Autistic Center
• So Love Autistic Center
• Erin Marie Solana, OTR/L
• Inna Solovey, D.D.S

• Behavior Technician in Newtown Square, PA
• Providers in Newtown Square, PA by specialty
• Behavior Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.