Provider Demographics
NPI:1902177512
Name:SMITH MENTAL HEALTH ASSOC
Entity Type:Organization
Organization Name:SMITH MENTAL HEALTH ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORREIA-KENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-321-2296
Mailing Address - Street 1:601 S STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4054
Mailing Address - Country:US
Mailing Address - Phone:954-321-2296
Mailing Address - Fax:954-321-5399
Practice Address - Street 1:4265 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6044
Practice Address - Country:US
Practice Address - Phone:954-415-6140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty