Healthcare Provider Details

I. General information

NPI: 1760835656
Provider Name (Legal Business Name): DENISHA SMITH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 1ST AVE N STE 2M
ST PETERSBURG FL
33713-8637
US

IV. Provider business mailing address

3110 1ST AVE N SUITE 2M PMB 1235
ST PETERSBURG FL
33713
US

V. Phone/Fax

Practice location:
  • Phone: 706-495-0239
  • Fax:
Mailing address:
  • Phone: 706-495-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH18937
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMH18937
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: