Jason Andrew Smith, MA TLLP LLPC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6362009926 Issued in MI

Practice address

496 W Ann Arbor TRL Ste 101
Plymouth, MI 48170-6262

Phone

(734) 347-6562

NPI assigned

Nov 4, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1871316224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11536 ASPEN DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704597",
            "telephone_number": "734-347-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 W ANN ARBOR TRL STE 101",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706262",
            "telephone_number": "734-347-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "middle_name": "ANDREW",
        "credential": "MA TLLP LLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451023628",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362009926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Smith
• Holly Lee Smith, LLPC
• Jackee Smith
• Jacob Smith
• Janessa Smith
• Jenelle Smith
• Jocelyn M Smith, PTA
• Joshua T Smith, DPT
• Kathleen Marie Smith, RN, MSN, AGPCNP-BC
• Kristen Smith

• Psychologist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.