Shelly Smith

Primary specialty

Child Mental Illness Respite CareTaxonomy code 385HR2055X

License

BH4554 Issued in AZ

Practice address

6060 N Wildhorse Dr
Prescott Valley, AZ 86314-3346

Phone

(760) 644-3670

NPI assigned

Sep 18, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1609245752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 N WILDHORSE DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863143346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 N WILDHORSE DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863143346",
            "telephone_number": "760-644-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "BH4554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarisa Idalia Smith, M.D.
• Jack Smith, PHARMD
• Malorie Jo Smith, MS, LPC
• Nancy Renee Smith
• Paul Brian Smith, RPH
• Varena Lynn Smith
• Smiths Food & Drug Centers Inc
• Daniel Sobol, PTA
• Darshan Sojitra, RPH
• Solace Counseling,LLC

• Child Mental Illness Respite Care in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Child Mental Illness Respite Care in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.