Provider Demographics
NPI:1649499286
Name:SMOLENY, STORMY ALEXANDRIA (PHD, LMHC, NCPSYA)
Entity type:Individual
Prefix:DR
First Name:STORMY
Middle Name:ALEXANDRIA
Last Name:SMOLENY
Suffix:
Gender:F
Credentials:PHD, LMHC, NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19500 SW 129TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-4237
Mailing Address - Country:US
Mailing Address - Phone:305-238-6235
Mailing Address - Fax:305-253-1107
Practice Address - Street 1:9150 SW 87TH AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2319
Practice Address - Country:US
Practice Address - Phone:305-412-9885
Practice Address - Fax:305-253-1107
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1448101YM0800X
NY0005951102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ1695OtherBLUE CROSS, BLUE SHIELD