Cheryl Funsch Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20-07P Issued in AR

Practice address

2031 N Green Acres Rd Ste a
Fayetteville, AR 72703-2619

Phone

(615) 618-5166

NPI assigned

Dec 27, 2013

Last updated

Jun 11, 2020By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1497176093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 PRINCESS CIR",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370641422",
            "telephone_number": "615-618-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 N GREEN ACRES RD STE A",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032619",
            "telephone_number": "615-618-5166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Holiday Ct",
            "address_2": "Suite A2",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370673000",
            "country_code": "US",
            "telephone_number": "615-618-5166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHERYL",
        "middle_name": "FUNSCH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-27",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS008859L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3206",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "20-07P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Smith, PHARMD
• Brian Keith Smith, PHARMD
• Britte D Smith, M.D.
• Cerine Smith
• Charles E Smith
• Cody Ross Smith, M.D.
• Emma Smith
• Erica Smith
• Jacob Robert Smith, MD
• Janice Ruth Smith, PA-C

• Clinical Psychologist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.