Misty Lane Smith, PCMHT

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1213 Maria LN
Iuka, MS 38852-1135

Phone

(662) 423-3332

Fax

(662) 286-8095

NPI assigned

Jan 16, 2008

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

Other names 1

• Misty Lane Dickerson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1790961084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350839",
            "telephone_number": "662-286-2152",
            "fax_number": "662-286-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 MARIA LN",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388521135",
            "telephone_number": "662-423-3332",
            "fax_number": "662-286-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MISTY",
        "middle_name": "LANE",
        "credential": "PCMHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "DICKERSON",
            "middle_name": "LANE",
            "credential": "M.S.ED.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Sims, NP
• Valerie Vernice Sims
• Sitters and More, Inc.
• Sme I - Iuka, LLC
• Brian Keith Smith, MSW
• Crystal South, R.N.
• Teresa M South, NURSE PRACTITIONER
• Catherine Aston Spain
• Mary A Stewart, COTA
• Shayla R Sturdivant, DPT

• Counselor in Iuka, MS
• Providers in Iuka, MS by specialty
• Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.