Keeva Smith

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1402 S Saginaw St
Flint, MI 48503-3705

Phone

(810) 496-5777

NPI assigned

Nov 19, 2019

Reactivated

Feb 21, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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.

• Victory Clinical Services Lansing

  • Methadone Clinic
  • Lansing, MI
  • NPI 1861627507
  NPD (past)

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1508402157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8070 KENSINGTON BLVD APT 208",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232918",
            "telephone_number": "810-484-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S SAGINAW ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485033705",
            "telephone_number": "810-496-5777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5710 Clio Rd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485041525",
            "country_code": "US",
            "telephone_number": "810-406-4246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEEVA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "deactivation_date": "2024-02-01",
        "reactivation_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenette Bongiorno Smith, LMSW
• Jesse Smith, CRNA
• Jimeshia Smith
• Julie Anne Smith, MA, LPC, LMSW
• Katie M Smith
• Kimberly Kay Smith
• Latasha Smith
• Lyndsey Mary Smith, CRNA
• Maria E Smith, MD
• McKenzie Smith

• Community Health Worker in Flint, MI
• Providers in Flint, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.