Provider Demographics
NPI:1922561232
Name:SMITH, JOHNECE M
Entity Type:Individual
Prefix:
First Name:JOHNECE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100A SOUTHBRIDGE PKWY STE 650
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1377
Mailing Address - Country:US
Mailing Address - Phone:205-427-4921
Mailing Address - Fax:
Practice Address - Street 1:2100A SOUTHBRIDGE PARKWAY STE, 650
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1349
Practice Address - Country:US
Practice Address - Phone:205-427-4921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist