DR. BRENT RODERICK SMITH


Address: 6692 Spring Arbor Rd, Jackson, MI 49201
Phone: 5177503869

DR. BRENT RODERICK SMITH (NPI# 1558475012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558475012
Entity Type Individual
Full Name DR. BRENT RODERICK SMITH
Credential PSY.D.
Practice Address 6692 Spring Arbor Rd
Jackson
MI 49201
Mailing Address 6692 Spring Arbor Rd
Jackson
MI 49201-9322
Practice Telephone 5177503869
Practice Fax Number 5177503869
Mailing Telephone 5177503869
Mailing Fax Number 5177503673
Enumeration Date 2006-08-19
Last Update Date 2018-08-17
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
6301008782 MI Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI BLUE CROSS BLUE SHIELD MI 680C845330 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
818 Winifred St, Jackson, MI 492023062 5175133617 5177963104

Other Providers BRENT SMITH

NPI Name Taxonomy Address Enumeration
1467903641 Brent Smith Counselor 872 Flournoy Lucas Rd, Shreveport, LA 71118-4133 2016-10-21
1396291167 Brent Timothy Smith Specialist 151 Ribault Street Suite 200, Spartanburg, SC 29302 2016-08-31
1477825297 Brent Thomas Smith Chiropractor 12 Eagleview Ln, Schwenksville, PA 19473 2012-02-09
1437384468 Brent Smith Chiropractor 5501 W Highway 290, Suite B, Austin, TX 78735-8803 2009-05-20
1033325485 Brent Smith Day Training, Developmentally Disabled Services 100 Pytchley Ct, Longwood, FL 32779-5745 2007-05-15
1154450617 Brent Irvin Smith Specialist/Technologist 146d Recreation Hall, The Pennsylvania State University, University Park, PA 16802-6501 2007-03-02
1376186064 Brent Smith Registered Nurse 562 Wyoming Ave, Kingston, PA 18704-3721 2019-10-24
1760977672 Brent Robert Smith Dentist 140 Mahaley Ave, Salisbury, NC 28144-2449 2018-06-25
1235635053 Brent Jerald Smith Jr. Student in an Organized Health Care Education/Training Program 3901 Rainbow Blvd # Ms 2027, Kansas City, KS 66160-8500 2018-04-02
1396147310 Brent Warren Smith Psychologist 1935 Medical District Dr, Mailstop El180.03, Dallas, TX 75235-7701 2014-09-22

Office Location

Street Address 6692 SPRING ARBOR RD
City JACKSON
State MI
Zip Code 49201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003372368 Chelsea Kae Wells Psychologist 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2019-02-12
1427540913 Randall Eric Cole Counselor 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2018-05-31
1407392731 Matthew Smith Psychologist 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2017-01-10
1093187338 Elisabeth Smith Psychologist 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2015-10-27
1366860470 Kelly Tervol Counselor 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2014-04-04
1336576073 Lissa Lynn Cole Counselor 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2013-09-26
1942549779 Bethany Kaye Saunders Counselor 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2013-02-14
1538423678 Jamie Lea Lee Counselor 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2012-07-03
1295051514 Joell Lavonne Sanchez-deleon Psychologist 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2010-04-12
1336475177 Rachel Flowers Social Worker 6692 Spring Arbor Rd, Jackson, MI 49201-9322 2009-10-29
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174137863 Sally Ann Shaw Behavior Technician 3699 Miles Rd., Jackson, MI 49201 2020-09-01
1780293043 Alyn Kristin Kay Technician Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 2020-07-23
1841827946 Maverick Jubane Student in an Organized Health Care Education/Training Program Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 2020-03-26
1306486584 Cody Williams Technician, Other 1001 Laurence Avenue St E, Jackson, MI 49201 2020-01-15
1720632292 Krystie Lynn Adorjan Speech-Language Pathologist 1175 W Parnall Rd, Jackson, MI 49201 2019-08-01
1407412653 Howard Franklin Tanner II Speech-Language Pathologist 102 East Michigan Avenue, Jackson, MI 49201 2019-05-14
1356863740 Rima Zarar Qayyum Speech-Language Pathologist 4800 Firethorn Dr., Jackson, MI 49201 2017-07-07
1306384383 Briana Nesmith Speech-Language Pathologist 2025 Ann Arbor Road, Jackson, MI 49201 2017-02-09
1255878062 W.a. Foote Memorial Hospital, Inc Otolaryngology 205 N.east Ave, Jackson, MI 49201 2017-01-31
1306212881 Aisha Henderson Social Worker 729 West Michigan Avenue, Jackson, MI 49201 2015-08-19
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043756174 Maribeth L. Hesser Psychologist 6675 N Upper Cascade Dr, Jackson, WY 83001-9390 2017-01-12
1215375746 Payne Behavioral Medicine Psychologist 4005 N State St Ste N, Jackson, MS 39206-5755 2013-06-06
1598002610 Kimberly D Weaver Psychologist 207 First Street, Jackson, MI 49201 2013-01-09
1497027775 Fitness Clinic Psychologist 2219 Greenway Dr, Jackson, MS 39204-3202 2012-02-02
1760752976 Mitchell S. Weisbrod, Psy.d., Pllc Psychologist 115 S West Ave Ste 1, Jackson, MI 49201-2085 2012-01-04
1275830887 Martin E Cleveland Phd Pllc Psychologist 5 Brentmeade Cv, Jackson, TN 38305-6448 2011-02-16
1154636611 Shannon Monique Moore Psychologist 1675 Lakeland Dr Ste 304, Jackson, MS 39216 2010-08-09
1598076903 Nanetta S Payne Psychologist 4005 N State St, Suite N, Jackson, MS 39206-5755 2010-06-30
1932422763 Marion Counseling Services, Pllc Psychologist 2095 Dunbarton Dr, Suite 103, Jackson, MS 39216-5017 2010-03-08
1457548737 Deborah Ruddy Hansen Psychologist 6 Universal Way, Jackson, MI 49202-1455 2007-10-01
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Competitor

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City JACKSON
Zip Code 49201

Improve Information

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Dataset Information

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.

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