Althea Smith, MENTAL HEALTH

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401014365 Issued in MI

Practice address

26677 W 12 Mile Rd Ste 136
Southfield, MI 48034-1514

Phone

(248) 990-6384

NPI assigned

Aug 27, 2014

Sex

Female

Sole proprietor

Yes

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

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.

• Envision Wellness LLC

  • Adult Mental Health Clinic/Center
  • Southfield, MI
  • NPI 1730682253
  NPD (past) Authorized official

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1871993840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26677 W 12 MILE RD STE 136",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341514",
            "telephone_number": "248-990-6384",
            "fax_number": "313-924-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26677 W 12 MILE RD STE 136",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341514",
            "telephone_number": "248-990-6384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 N. Oakland Blvd",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483271549",
            "country_code": "US",
            "telephone_number": "248-406-0090",
            "fax_number": "248-406-0107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALTHEA",
        "credential": "MENTAL HEALTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401014365",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mondale Smiley
• Ajax Smit
• Smith Cannady Counseling Associates Inc
• Phina Smith-Hamilton, LMSW
• Alexis Smith
• Amanda Dawn Smith
• Amy Smith
• Angelique Smith
• Arthur Smith, LCSW
• Azarhia Smith

• Professional Counselor in Southfield, MI
• Providers in Southfield, MI by specialty
• Professional Counselor in Michigan

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