Provider Demographics
NPI:1245974849
Name:SMITH, JOSEPHANIE VELSHEE (MS)
Entity type:Individual
Prefix:
First Name:JOSEPHANIE
Middle Name:VELSHEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 HARTINGTON PL
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4992
Mailing Address - Country:US
Mailing Address - Phone:404-333-3181
Mailing Address - Fax:
Practice Address - Street 1:700 OLD ROSWELL LAKES PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1612
Practice Address - Country:US
Practice Address - Phone:678-210-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health