MEDICARE: MR. RANDAL GENE SMITH CADC, AAS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CADC	MI

General Provider Information

NPI Number	:	1861839300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RANDAL GENE SMITH CADC, AAS

Provider Business Mailing Address
First Line	:	4310 HUCKLEBERRY LN
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48507-2358
Country	:	US
Telephone Number	:	810-962-5139
Fax Number	:

Provider Business Practice Location Address
First Line	:	529 MARTIN LUTHER KING JUNIOR BLVD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48502-2002
Country	:	US
Telephone Number	:	810-238-0483
Fax Number	:

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

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	05/24/2013

Similar Medicare Providers

1093703589 — DR. DAVID MATTHEW TYKOCKI O.D.
Practice Location Address:

523 M L KING AVE
FLINT, MI
48502-2002

Practice Phone: 810-238-0925
Practice Fax: 810-238-6641

1528075116 — SHANE PATRICK KING O.D.
Practice Location Address:

523 M L KING AVE
FLINT, MI
48502-2002

Practice Phone: 810-238-0925
Practice Fax:

1790854305 — RONNIE TYSON
Practice Location Address:

529 M L KING AVE
FLINT, MI
48502-2002

Practice Phone: 810-232-7919
Practice Fax: 810-232-7913

1215118138 — MS. KIMBERLY MEG SHEWMAKER LMSW, CAADC, CCDP-D
Practice Location Address:

529 M L KING AVE
FLINT, MI
48502-2002

Practice Phone: 810-238-7226
Practice Fax:

1700156783 — NEVA L. JOHNSON N.P.
Practice Location Address:

529 M L KING AVE
FLINT, MI
48502-2002

Practice Phone: 810-238-7226
Practice Fax: 810-239-5518

1861837502 — SHANTA NATRE SMITH MS, LLBSW, CADC
Practice Location Address:

529 MARTIN LUTHER KING BLVD
FLINT, MI
48502-2002

Practice Phone: 810-232-5641
Practice Fax:

Directions to “ MR. RANDAL GENE SMITH CADC, AAS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.