MEDICARE: DR. SHANEIKA SMITH PHD, LPC-MHSP

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	101YM0800X	Mental Health Counselor	5350	TN
2	101YS0200X	School Counselor	000562213	TN
3	101YP2500X	Professional Counselor	5350	TN

General Provider Information

NPI Number	:	1669763629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANEIKA SMITH PHD, LPC-MHSP

Provider Business Mailing Address
First Line	:	10640 BIRD STONE CV
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-5561
Country	:	US
Telephone Number	:	901-756-1510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2899 S MENDENHALL RD STE 1
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2247
Country	:	US
Telephone Number	:	901-245-3220
Fax Number	:	901-370-3265

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

Provider Enumeration Date	:	04/26/2011
Last Update Date	:	06/01/2026

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