Mi-Chaelah H Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37FA00020600 Issued in NJ

Practice address

395 S Center St
Orange, NJ 07050-3205

Phone

(973) 323-3389

NPI assigned

Sep 20, 2021

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.

• Family Service Bureau of Newark

  • Community/Behavioral Health Agency
  • Newark, NJ
  • NPI 1376673814
  NPD (past)
• Family Service Bureau of Newark

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kearny, NJ
  • NPI 1396994588
  NPD (past)

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1942970033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 S CENTER ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070503205",
            "telephone_number": "973-323-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 S CENTER ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070503205",
            "telephone_number": "973-323-3389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MI-CHAELAH",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37FA00020600",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37FA00020600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Shaughnessy
• Briana Shaw
• Franck Ayouba Sidibe
• Sis Transport LLC
• SJT Creative Inc.
• Taneisha Smith
• Lori Jill Sonenblum, LSW, LCADC
• Sonia Jimenez Soria, APN
• South Center Street Nursing Home, LLC
• South Center Street Nursing Home, LLC

• Mental Health Counselor in Orange, NJ
• Providers in Orange, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.