Brent Roderick Smith in Jackson - Clinical
Brent Roderick Smith - NPI 1558475012
Brent Roderick Smith is a Clinical in Jackson, Michigan. Brent Roderick Smith practices all healthcare services and medical treatments related to Clinical. The NPI Number for Brent Roderick Smith is 1558475012. The last update date is 2018-08-17.
Brent Roderick Smith's current location address is 6692 Spring Arbor Rd, Jackson, Michigan. You can contact this provider via phone number 5177503869 and fax number 5177503673. The mailing address for Brent Roderick Smith is 6692 Spring Arbor Rd, Jackson, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brent Roderick Smith |
|---|---|
| Address | 6692 Spring Arbor Rd, Jackson, Michigan |
| Phone Number | 5177503869 |
| Fax Number | 5177503673 |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1558475012 |
|---|---|
| Provider Enumeration Date | 2006-08-19 |
| Last Updated Date | 2018-08-17 |
Provider Mailing Address Detail
| Address | 6692 Spring Arbor Rd |
|---|---|
| City | Jackson |
| State | Michigan (MI) |
| Post Code | 492019322 |
| Phone Number | 5177503869 |
| Fax Number | 5177503673 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 6301008782 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 680C845330 | MI | BLUE CROSS BLUE SHIELD MI |
Post Comment/ Review Below
What is the unique identifier code issued to Brent Roderick Smith by the Centers for Medicare & Medicaid Services?
The Brent Roderick Smith has been assigned the NPI (National Provider Identifier) 1558475012. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Brent Roderick Smith is physically located?
The Brent Roderick Smith is situated at the following address: 6692 Spring Arbor Rd, Jackson, MI 492019322.
What is Brent Roderick Smith's specialized field of practice, and what is the corresponding taxonomy classification code?
The Brent Roderick Smith's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
On what date was the 1558475012 assigned to Brent Roderick Smith?
The Brent Roderick Smith was issued its 1558475012 on 2006-08-19, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Brent Roderick Smith, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Brent Roderick Smith, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2018-08-17.