DERRICK SMITH (NPI# 1750546412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750546412 |
| Entity Type | Individual |
| Full Name | DERRICK SMITH |
| Practice Address |
12714 Avalon Blvd Los Angeles CA 90061-2730 |
| Practice Telephone | 3232425000 |
| Mailing Telephone | 3232425000 |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2009-11-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942767173 | Derrick Wade Smith | Technician | 8670 Silver Shores Dr, Reno, NV 89506-2153 | 2019-02-24 |
| 1003366840 | Derrick Smith | Contractor | 100 Medley Dr, Leesburg, GA 31763-3272 | 2016-10-05 |
| 1801295654 | Derrick Smith | Physical Therapy Assistant | 6410 Seminole Dr, West Chester, OH 45069-1329 | 2014-08-18 |
| 1023443892 | Derrick Smith | Counselor | 1866 Green River St, Las Vegas, NV 89142-1273 | 2013-09-11 |
| 1457564841 | Derrick Trigenza Smith | Dental Hygienist | 23569 Sunnymead Ranch Parkway, Moreno Valley, CA 92557 | 2007-05-08 |
| 1780679894 | Derrick L. Smith | Family Medicine | 1861 W Redlands Blvd, Building 7b, Redlands, CA 92373-3119 | 2005-09-14 |
| 1457960098 | Derrick Garner Smith | Speech-Language Pathologist | 24422 Avenida De La Carlota Ste 190, Laguna Hills, CA 92653-3634 | 2020-07-29 |
| 1538791710 | Derrick Smith | Behavior Technician | 3601 E 11 Mile Rd, Warren, MI 48092-2878 | 2020-02-06 |
| 1205346582 | Derrick Smith | Counselor | 403 Commerce St, Ripley, TN 38063-2060 | 2017-10-02 |
| 1740734029 | Derrick Brice Smith | Physical Therapist | 276 Nissan Pkwy, Suite 400, Bldg F, Canton, MS 39046-7006 | 2016-08-04 |
| Street Address |
12714 AVALON BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90061-2730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154451102 | Giselle L. Gourrier | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2007-03-07 |
| 1487958740 | Medi Cure Health Services, Inc | Community/Behavioral Health | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2010-12-30 |
| 1003067273 | Sarah Mojtahedi | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-10-07 |
| 1710138078 | Brittany Carraway | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-10-06 |
| 1588814305 | Nailah Wilder | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-09-29 |
| 1366699795 | Margaruite Evans | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-08-27 |
| 1225285968 | Kenia Mendez | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-08-25 |
| 1629234190 | Rinnah Hunnicutt-ramirez | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-08-04 |
| 1871756213 | Camille Forby | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-07-07 |
| 1447410170 | Yolanda Avitia | Counselor | 12714 Avalon Blvd, Los Angeles, CA 90061-2730 | 2008-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447882782 | Golden State Recuperative Care, Inc. | Lodging | 153 E. 110th St, Los Angeles, CA 90061 | 2020-02-05 |
| 1235695974 | Phyllis Kirby Tisdale | Nurse Practitioner | 145 E 124th Street, Los Angeles, CA 90061 | 2019-02-19 |
| 1003160003 | Alicia Vera | Counselor | 245 E 120th Street, Los Angeles, CA 90061 | 2012-10-30 |
| 1194044974 | Helping Kids To Recover, Inc. | Substance Abuse Rehabilitation Facility | 12628 Avalon Boulevard, Los Angeles, CA 90061 | 2010-05-19 |
| 1124202817 | David Anthony Martinez | Counselor | 11900 S. Avalon Blvd, 1, Los Angeles, CA 90061 | 2007-12-18 |
| 1255538690 | Ceed Security Services Inc | Durable Medical Equipment & Medical Supplies | 12815 South Avalon Blvd, Los Angeles, CA 90061 | 2007-06-29 |
| 1134335128 | Parklane Medical Group | Family Medicine | 12900 South Avalon Bl., Los Angeles, CA 90061 | 2007-05-15 |
| 1598892184 | Jose Rodriguez | Counselor | 11900 S. Avalon Blvd., Suite 200, Los Angeles, CA 90061 | 2007-02-28 |
| 1316182975 | Luis Rabago | Counselor | 11900 Avalon Blvd, Suite 200, Los Angeles, CA 90061 | 2008-12-11 |
| 1619169406 | Emmanuel A Ayodele | General Practice | 11126 S Main St, Los Angeles, CA 90061 | 2007-08-15 |
| Find all providers in zip 90061 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913055 | Jose Islas | Counselor | 4396 1/2 Lovett St, Los Angeles, CA 90023-4117 | 2020-08-19 |
| 1154931491 | Delia Maria Cortez | Counselor | 12133 Clarkson Rd, Los Angeles, CA 90064-3519 | 2020-08-02 |
| 1457974263 | Simeon Simov | Counselor | 11845 W Olympic Blvd # 815e, Los Angeles, CA 90064-1149 | 2020-05-27 |
| 1780206524 | Keisha Whitfield | Counselor | 1123 W 7th St # 25, Los Angeles, CA 90017-2409 | 2020-05-14 |
| 1467073965 | Flowlab Inc | Counselor | 4528 Los Feliz Blvd, Los Angeles, CA 90027-2006 | 2020-05-06 |
| 1619504925 | Tanisha N Tatum | Counselor | 5777 W Century Blvd # 11102035, Los Angeles, CA 90045-5600 | 2020-03-25 |
| 1083241988 | Rezolve Telemed | Counselor | 8275 Kirkwood Dr, Los Angeles, CA 90046-1923 | 2020-03-23 |
| 1902439656 | Maria Velazquez | Counselor | 5318 S Crenshaw Blvd, Los Angeles, CA 90043-1810 | 2020-02-20 |
| 1922647569 | Ping Sun | Counselor | 520 S Sepulveda Blvd Ste 200, Los Angeles, CA 90049-3534 | 2019-12-30 |
| 1780233213 | Rafael Martin Perez | Counselor | 5955 Hooper Ave Apt A, Los Angeles, CA 90001-1292 | 2019-09-06 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90061 |
Please comment or provide details below to improve the information on DERRICK SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.