Provider Demographics
NPI:1902050560
Name:NESMITH, MICHELE (LMFT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:NESMITH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:110 E BROWARD BLVD
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-3503
Mailing Address - Country:US
Mailing Address - Phone:954-980-4450
Mailing Address - Fax:
Practice Address - Street 1:110 E BROWARD BLVD
Practice Address - Street 2:SUITE 1600
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-3503
Practice Address - Country:US
Practice Address - Phone:954-980-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2585106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist