Robert B Smith Jr., PSYD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60795300 Issued in WA

Practice address

2830 228TH Ave SE Ste C
Sammamish, WA 98075-9300

Phone

(425) 677-0966

NPI assigned

Mar 11, 2019

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Jun 16, 2025 through Jun 16, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Avanti

  • Mental Health Counselor
  • Sammamish, WA
  • NPI 1932618014
  NPD (past)

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1841758653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 228TH AVE SE STE C",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759300",
            "telephone_number": "425-677-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 228TH AVE SE STE C",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759300",
            "telephone_number": "425-677-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60795300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashima Singal, D.D.S
• Meenakshi Singh
• Cale Smart
• Liudmila Smelovskaia
• Brandon E Smith, MSN, FNP-C
• Sivan So, BCBA
• Emily Alene Solie, PT
• Sometimes Quiet Desperation
• Christopher S Son
• Wenjia Song, ARNP

• Mental Health Counselor in Sammamish, WA
• Providers in Sammamish, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.