DR. SHANNON MARIE SMITH PH.D.
NPI 1548747181
Psychologist in Winter Haven, FL

Active since July 26, 2018PECOS EnrolledAccepts Medicare Assignment
1201 1ST ST S STE 100A, WINTER HAVEN, FL 33880(863) 280-6080(863) 229-7587 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 25, 2021, Dec 30, 2020, Dec 7, 2020 and 1 more (4 updates tracked since 2018).

About Dr. Shannon Marie Smith Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANNON MARIE SMITH PH.D. (NPI 1548747181) is an individual psychologist in Winter Haven, Florida, licensed in Florida (PY10219) and active in the NPI registry since July 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1548747181
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. SHANNON MARIE SMITHCredential: PH.D.
Location Address1201 1ST ST S STE 100AWinter Haven, FL 33880-3904
Mailing Address2995 Drew St Fl 2Clearwater, FL 33759-3012 · (727) 532-1355 · Fax (813) 635-2613
Fax(863) 229-7587
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJuly 26, 2018
Last NPPES UpdateMarch 25, 20214 updates tracked since enumeration
NPPES CertifiedMarch 25, 2021
NPI 1548747181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in FL · PY10219
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

1201 1ST ST S STE 100A, Winter Haven, FL 33880

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Shannon Marie Smith Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385056613
PECOS Enrollment IDI20201210001398
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880
Family Medicine
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880
Student in an Organized Health Care Education/Training Program
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880
Family Medicine
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880
Family Medicine
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880
Student in an Organized Health Care Education/Training Program
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880
Student in an Organized Health Care Education/Training Program
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880
Student in an Organized Health Care Education/Training Program
1201 1ST ST S STE 100A
WINTER HAVEN, FL 33880

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548747181, enumerated as an "individual" on July 26, 2018.

The provider is located at 1201 1ST ST S STE 100A WINTER HAVEN, FL 33880 and the phone number is (863) 280-6080.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: AvMed, Florida Blue (BlueCross BlueShield FL),. Please consult your insurance carrier or call the provider to verify.