# HANCOCK-SMITH PEDIATRIC & BEHAVIORAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396354858
- **Authorized official:** DR. ANYALIESE DOMINIQUE HANCOCK-SMITH PHD (OWNER & LICENSED PSYCHOLOGIST)
- **Authorized official phone:** (386) 518-6006

## Contact information

- **Practice address:** 13900 TECH CITY CIR STE 408, ALACHUA, FL 32615-6090
- **Practice address phone:** (386) 518-6006
- **Practice address fax:** (386) 518-6024
- **Mailing address:** PO BOX 305, ALACHUA, FL 32616-0305
- **Mailing address phone:** (386) 518-6006
- **Mailing address fax:** (385) 518-6024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/29/2020
- **Last updated:** 08/02/2021