Healthcare Provider Details

I. General information

NPI: 1740344456
Provider Name (Legal Business Name): BARBARA JONES SMITH PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W 11TH ST # 1W
TRAVERSE CITY MI
49684-3002
US

IV. Provider business mailing address

921 W 11TH ST # 1W
TRAVERSE CITY MI
49684-3002
US

V. Phone/Fax

Practice location:
  • Phone: 231-947-1444
  • Fax: 231-947-2444
Mailing address:
  • Phone: 231-947-1444
  • Fax: 231-947-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number6301007417
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6301007417
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301007417
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number6301007417
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number6301007417
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number6301007417
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number6301007417
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number6301007417
License Number StateMI
# 9
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301007417
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: