Tamisha Nicole Kelly Smith, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC2688 Issued in MD

Practice address

6188 Oxon Hill Rd Ste 500
Oxon Hill, MD 20745-3136

Phone

(307) 567-0400

NPI assigned

May 24, 2010

Last updated

Jan 31, 2019By 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

Other names 1

• Tamisha Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1417276999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8702 GRASSLAND CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034916",
            "telephone_number": "301-922-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6188 OXON HILL RD STE 500",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453136",
            "telephone_number": "307-567-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Forbes Blvd",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207064342",
            "country_code": "US",
            "telephone_number": "301-577-7390",
            "fax_number": "301-577-7392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAMISHA",
        "middle_name": "NICOLE KELLY",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-24",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC2688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMISHA",
            "last_name": "KELLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Oxon Hill, MD
• Providers in Oxon Hill, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.