Tanisha Smith

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851117318 Issued in MI

Practice address

610 S Burdick St
Kalamazoo, MI 49007-5221

Phone

(269) 716-8690

NPI assigned

Nov 2, 2023

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

State licenses

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1962275818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 CROYDEN AVE APT 5202",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093357",
            "telephone_number": "269-716-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075221",
            "telephone_number": "269-716-8690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Croyden Ave Apt 5202",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490093357",
            "country_code": "US",
            "telephone_number": "269-716-8690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TANISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851117318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Steven Smith, MD
• Sarah Elizabeth Smith, CTRS
• Shannon M Smith, COTA
• Shanta Smith
• Shonna Shaneice Smith, RN
• Tianna Smith, LLMSW
• Veronica Ann Smith
• Will H Smith
• Zachary Robert Smith, DO
• Zoeann Smith

• Clinical Social Worker in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.