Provider Demographics
NPI:1003032343
Name:SMITH, CARA LEANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:LEANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 CHELSEA CT APT A
Mailing Address - Street 2:
Mailing Address - City:LAKE CLARKE SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33406-8414
Mailing Address - Country:US
Mailing Address - Phone:561-641-3086
Mailing Address - Fax:561-641-3086
Practice Address - Street 1:1218 SOUTH OLIVE AVE.
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6725
Practice Address - Country:US
Practice Address - Phone:561-641-3086
Practice Address - Fax:561-641-3086
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7361103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist