Healthcare Provider Details

I. General information

NPI: 1659449007
Provider Name (Legal Business Name): JULIE SMITHEE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 KALAMAZOO AVE SE STE C
CALEDONIA MI
49316-9197
US

IV. Provider business mailing address

2868 COURT DR SE
LOWELL MI
49331-9066
US

V. Phone/Fax

Practice location:
  • Phone: 616-550-2111
  • Fax:
Mailing address:
  • Phone: 616-550-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301009712
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: