Healthcare Provider Details

I. General information

NPI: 1720488281
Provider Name (Legal Business Name): BRIAN SMERDON MS LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 BIG TREE RD UNIT L7
SOUTH DAYTONA FL
32119-8937
US

IV. Provider business mailing address

1600 BIG TREE RD UNIT L7
SOUTH DAYTONA FL
32119-8937
US

V. Phone/Fax

Practice location:
  • Phone: 386-293-2318
  • Fax:
Mailing address:
  • Phone: 386-562-7540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: