MEDICARE: TRINITY SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst		TN

General Provider Information

NPI Number	:	1609728658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINITY SMITH

Provider Business Mailing Address
First Line	:	207 EVENINGSIDE DR
Second Line	:
City	:	SODDY DAISY
State	:	TN
Zip	:	37379-4336
Country	:	US
Telephone Number	:	978-400-0814
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 MCMINN AVE
Second Line	:
City	:	ATHENS
State	:	TN
Zip	:	37303-4106
Country	:	US
Telephone Number	:	423-745-3862
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “ TRINITY SMITH ” Practice Location

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