Provider Demographics
NPI:1649078312
Name:SMITH, SHELBY JANEAN (MS)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:JANEAN
Last Name:SMITH
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:HENLEY
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7311 CLINTON HWY STE B
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5224
Mailing Address - Country:US
Mailing Address - Phone:417-262-4012
Mailing Address - Fax:
Practice Address - Street 1:7311 CLINTON HWY STE B
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5224
Practice Address - Country:US
Practice Address - Phone:417-262-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health