Michelle Smith, REVEREND

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF40419 Issued in CA

Practice address

3990 Branch Center Rd # 95827
Serna Center 5735 47TH Avenue
Sacramento, CA 95827-3809

Phone

(916) 743-3856

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Michelle Smith Professional 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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508972951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6733 DEMARET DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958223934",
            "telephone_number": "916-393-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 BRANCH CENTER RD # 95827",
            "address_2": "SERNA CENTER 5735 47TH AVENUE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958273809",
            "telephone_number": "916-743-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHELLE",
        "name_prefix": "Prof.",
        "credential": "REVEREND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF40419",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "CA",
            "license": "IMF40419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD REGISTRATION NUMBER",
            "identifier": "40419",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "SMITH",
            "prefix": "MRS.",
            "credential": "MFT-INTERN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mauresha Denaye' Smith
• Maya Jazmin Smith, MD
• Melissa Kay Smith, D.P.T, A.T.C.
• Micheal Smith, PA
• Michele Lynn Pettit Smith, RN
• Miguel Smith
• Monica Smith
• Monika Letitia Smith
• Mya Anne-Marie Smith
• Natalie Smith, BCBA

• Mental Health Counselor in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.