Jacqueline Rae Smith, RBT, QMHPC

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT21152347 Issued in VA

Practice address

1741 Hiawatha Dr
Virginia Beach, VA 23464-8448

Phone

(757) 266-3430

NPI assigned

Oct 22, 2021

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

Electronic endpoints 1

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": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1548924996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 HIAWATHA DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234648448",
            "telephone_number": "757-266-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 HIAWATHA DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234648448",
            "telephone_number": "757-266-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "RAE",
        "credential": "RBT, QMHPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0733007985",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RBT21152347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackie@sunshinebehavioralconsulting.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1741 Hiawatha Dr",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234648448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Howard Clayton Smith Jr., M.D.
• Ian Everett Smith
• Imani M Smith, LPC
• Jacob Smith, DO
• Jacqueline Brown Smith, D.D.S.
• James Ellis Smith, DC
• Jaquana Smith
• Jeffrey P Smith, MD
• Jennifer Nicole Smith
• Jessica Smith, PSY.D.

• Behavior Technician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.