Michaela D.M. Smith, PSYD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5813 Issued in MN

Practice address

1925 Woodwinds Dr
Woodbury, MN 55125-2270

Phone

(651) 232-0100

NPI assigned

Sep 10, 2012

Last updated

Feb 5, 2016By the provider in NPPES

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)

Enrolled

State licenses

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1982953675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "address_2": "6TH FLOOR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-2273",
            "fax_number": "651-232-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 WOODWINDS DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252270",
            "telephone_number": "651-232-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAELA",
        "middle_name": "D.M.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Elizabeth Smith
• Lauren Lee Smith
• Laurie Anne Smith, DO
• Madison Smith
• Mark Edward Smith, D.O.
• Nikayla Lauren Smith
• Robert Weston Smith, MD
• Shannon Smith, PA-C
• Sheila Maureen Smith
• Thomas R Smith, MD

• Clinical Psychologist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.