Provider Demographics
NPI:1821401555
Name:SMITH, DANA LACHELLE (MHSA)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:LACHELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MHSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 COLDSPRING LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4209
Mailing Address - Country:US
Mailing Address - Phone:313-874-8715
Mailing Address - Fax:
Practice Address - Street 1:5215 COLDSPRING LN
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4209
Practice Address - Country:US
Practice Address - Phone:313-874-8715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)