Provider Demographics
NPI:1457222309
Name:SMITH, JAILEEN CECILIA
Entity type:Individual
Prefix:
First Name:JAILEEN
Middle Name:CECILIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 SOUTH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-8243
Mailing Address - Country:US
Mailing Address - Phone:413-236-5656
Mailing Address - Fax:
Practice Address - Street 1:877 SOUTH ST STE 200
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-8243
Practice Address - Country:US
Practice Address - Phone:413-236-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor