Provider Demographics
NPI:1326100975
Name:SMITH, HELEN (PDHD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PDHD
Other - Prefix:MS
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:8905 KINGSTON PIKE
Mailing Address - Street 2:12 230
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5005
Mailing Address - Country:US
Mailing Address - Phone:865-679-1205
Mailing Address - Fax:
Practice Address - Street 1:5401 KINGSTON PIKE
Practice Address - Street 2:285
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5022
Practice Address - Country:US
Practice Address - Phone:865-679-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001946103TC0700X, 103TF0200X, 103T00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3983881Medicare ID - Type UnspecifiedMEDICARE