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1255752986 NPI number — FAITH A SMITH LLPC

NPI Number: 1255752986
Health Care Provider/Practitioner: FAITH A SMITH LLPC

Information about “1255752986” NPI (FAITH A SMITH LLPC) exists in 1255752986 in HTML format HTML  |  1255752986 in plain Text format TXT  |  1255752986 in PDF (Portable Document Format) PDF  |  1255752986 in an XML format XML  formats.

NPI Number : 1255752986 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255752986",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SMITH",
    "FirstName": "FAITH",
    "MiddleName": "A",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LLPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "DOERZBACHER",
    "OtherFirstName": "FAITH",
    "OtherMiddleName": "A",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3315 ELK STREET",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORT HURON",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48060-2036",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "586-823-1028",
    "MailingAddressFaxNumber": "810-696-7339",
    "FirstLinePracticeLocationAddress": "1024 SUPERIOR STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORT HURON",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48060-3936",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "810-966-0099",
    "PracticeLocationAddressFaxNumber": "810-696-7339",
    "EnumerationDate": "12/23/2013",
    "LastUpdateDate": "03/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "04/19/2017",
    "NPIReactivationDate": "03/13/2025",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "6451024169",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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