Serena E Smith, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

276065 Issued in KY

Practice address

115 Little St
Manchester, KY 40962-1233

Phone

(606) 391-6224

NPI assigned

Apr 26, 2022

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Magnolia Tree Therapy, LLC

  • Speech-Language Pathologist
  • Manchester, KY
  • NPI 1447926894
  NPD

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1851035703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LITTLE ST",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621233",
            "telephone_number": "606-391-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LITTLE ST",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621233",
            "telephone_number": "606-391-6224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Medpark Dr",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425032734",
            "country_code": "US",
            "telephone_number": "606-679-1761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SERENA",
        "middle_name": "E",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "276065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Jo Smith, OTRL
• Kenna Smith
• Khercie Smith, MD
• Rachael Lee Smith
• Rhonda Renee Smith
• Sherri Larae Smith, APRN
• Suzann Smith, APRN
• Tara Lee Smith, APRN
• Tonya Smith, PT
• Smith'S Hometown Family Practice, LLC

• Speech-Language Pathologist in Manchester, KY
• Providers in Manchester, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.