SHANNON DEVAUGHN SMITH (NPI# 1326669888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326669888 |
| Entity Type | Individual |
| Full Name | SHANNON DEVAUGHN SMITH |
| Practice Address |
17400 Northwood Ave Lakewood OH 44107-2210 |
| Practice Telephone | 2164038640 |
| Mailing Telephone | 2164038640 |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
000332976 | OH | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | APP-000332976 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568203 | Shannon Smith | Counselor | 99 Huckleberry Ct, Three Bridges, NJ 08887-2109 | 2020-11-08 |
| 1821603267 | Shannon Alexandria Smith | Dietitian, Registered | 20621 Ne 1st Ct, Miami, FL 33179-1702 | 2020-09-12 |
| 1790316040 | Shannon Machelle Smith | Nurse Practitioner | 7705 Happy Hollow Dr, Mint Hill, NC 28227-8518 | 2020-01-27 |
| 1750925392 | Shannon Joy Smith | Nurse Practitioner | 152 Pearson Rd, Greer, SC 29651-7146 | 2019-11-06 |
| 1104308014 | Shannon Lynn Smith | Massage Therapist | 15131 Northville Rd, Plymouth, MI 48170-2548 | 2018-09-06 |
| 1548747181 | Shannon Marie Smith | Psychologist | 146 2nd St N Ste 305, Saint Petersburg, FL 33701-3361 | 2018-07-26 |
| 1942726393 | Shannon Elizabeth Smith | Counselor | 3535 S Sherwood Forest Blvd Ste 227, Baton Rouge, LA 70816-2255 | 2017-08-17 |
| 1043749450 | Shannon Michelle Smith | Marriage & Family Therapist | 707 W 5th Ave Apt 1116, Spokane, WA 99204-2780 | 2017-06-08 |
| 1033640644 | Shannon Elizabeth Smith | Social Worker | 212 W Red Bridge Rd, Kansas City, MO 64114-5136 | 2017-03-24 |
| 1518311240 | Shannon Kathleen Smith | Licensed Practical Nurse | 9040 Jackson Avenue, Attn Mchk-clq-c, Madigan Army Medical Center, Tacoma, WA 98431-1000 | 2016-04-19 |
| Street Address |
17400 NORTHWOOD AVE |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-2210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235520602 | John Joseph Smith | Counselor | 17400 Northwood Ave, Lakewood, OH 44107-2210 | 2015-02-06 |
| 1215329909 | Old School LLC | Clinic/Center | 17400 Northwood Ave, Lakewood, OH 44107-2210 | 2015-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407465826 | Polly L Jason | Counselor | 11720 Edgewater Dr Apt 816, Lakewood, OH 44107-6730 | 2020-07-31 |
| 1700409661 | Mechelle Lynn Schrage | Counselor | 4928 Pearce Ave, Lakewood, CA 90712-2751 | 2020-05-26 |
| 1487276325 | Teresa Rose Alvarez | Counselor | 1215 Nj-70 W, Lakewood, NJ 08701 | 2020-05-14 |
| 1659910750 | Dorothy Chippendale | Counselor | 501 Prospect St Bldg 1a, Lakewood, NJ 08701-5026 | 2020-01-06 |
| 1215597950 | Erika Lynn Marshall | Counselor | 15316 Grant Ave Sw, Lakewood, WA 98498-2019 | 2019-06-14 |
| 1629632542 | Lyndsey Klemme | Counselor | 13701 W Jewell Ave Ste 6, Lakewood, CO 80228-4139 | 2019-04-25 |
| 1003394446 | Robert Michael Schlesinger | Counselor | 5150 Candlewood St Ste 13a, Lakewood, CA 90712 | 2018-07-28 |
| 1952890584 | Kinue Langhofer | Counselor | 5706 W Asbury Pl Apt 102, Lakewood, CO 80227-2569 | 2018-05-09 |
| 1952801854 | Carol Jeanette Counts | Counselor | 2099 Wadsworth Blvd Ste P, Lakewood, CO 80214-5733 | 2018-02-16 |
| 1518475268 | Keith Douglas White | Counselor | 12050 Lake Ave Apt 504, Lakewood, OH 44107-1872 | 2018-01-16 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.