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Organization
DIANE S SMITH PC
Active
Organization
DIANE S SMITH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SHARON SMITH PHD APRN NP CNS (PRESIDENT)
(313) 882-7424
Entity
Organization
Contact information
Practice address
119 KERCHEVAL AVE, GROSSE POINTE FARMS, MI 48236-3696
(313) 881-2010
(313) 882-7424
Mailing address
1506 LOCHMOOR BLVD, GROSSE POINTE WOODS, MI 48236-4016
(313) 881-2010
(313) 882-7424
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301007629
MI
1041C0700X
Clinical Social Worker
Primary
6801017113
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
110675
MI
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
110675
MI
Other
Enumeration date
04/18/2006
Last updated
09/11/2025
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