Individual
DIANE SHARON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD MSW APRN BC CNS
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301007629
MI
1041C0700X
Clinical Social Worker
6801017113
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
110675
MI
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
110675
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008661290
BLUE CROSS BLUE SHIELD
MI
01
—
6301007629
CLINICAL PSYCHOLOGIST
MI
01
—
6801017113
CMSW
MI
Enumeration date
05/04/2007
Last updated
09/11/2025
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