Stacey Michelle Smith

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

7375 Woodward Ave Ste 2800
Detroit, MI 48202-3157

Phone

(313) 710-8744

Fax

(855) 568-1494

NPI assigned

Jun 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

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.

• Behavior Frontiers, LLC

  dba Behavior Frontiers

  • Behavior Analyst
  • Gardena, CA
  • NPI 1245539394
  NPD (past)

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1477284487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7375 WOODWARD AVE STE 2800",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023157",
            "telephone_number": "313-710-8744",
            "fax_number": "855-568-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 WOODWARD AVE STE 2800",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023157",
            "telephone_number": "313-710-8744",
            "fax_number": "855-568-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STACEY",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR TECH",
            "identifier": "106S00000X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawna Marie Smith, BS
• Shayna Smith
• Sheair Toyva Smith
• Shelby Smith
• Sonya Valjean Smith
• Stacy Smith
• Stephanie Smith
• Stephanie Smith, AODA/RECOVERY COACH
• Stephanie Lynn Smith, MSN, WHNP-BC
• Stephen T Smith, RPH, MS

• Behavior Technician in Detroit, MI
• Providers in Detroit, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.