Provider Demographics
NPI:1558385690
Name:SMITH, ERIN MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MICHELLE
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 1:100 ESSEX CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-3139
Mailing Address - Country:US
Mailing Address - Phone:256-774-7100
Mailing Address - Fax:256-774-7579
Practice Address - Street 1:100 ESSEX CT
Practice Address - Street 2:SUITE B
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3139
Practice Address - Country:US
Practice Address - Phone:256-774-7100
Practice Address - Fax:256-774-7579
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1197103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51512011OtherBCBS FEDERAL EMPLOYEES
AL51507014OtherBCBS PROVIDER NUMBER
AL2082972OtherFIRST HEALTH PROVIDER NUM
AL281495OtherUNITED HEALTH CARE
AL2082972OtherFIRST HEALTH PROVIDER NUM