Provider Demographics
NPI:1235880105
Name:SMITH BEHAVIORAL HEALTH AND WELLNESS
Entity type:Organization
Organization Name:SMITH BEHAVIORAL HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:615-933-8772
Mailing Address - Street 1:210 25TH AVE N STE 1220
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1640
Mailing Address - Country:US
Mailing Address - Phone:615-933-8772
Mailing Address - Fax:615-915-2627
Practice Address - Street 1:210 25TH AVE N STE 1220
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1640
Practice Address - Country:US
Practice Address - Phone:615-933-8772
Practice Address - Fax:615-915-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)