Smiley, Odetta

Smiley, Odetta is an sole proprietor health care provider with primary practice located at 185 Richard Davis Dr Ste 102 , Richmond Hill GA 31324-3978. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Smiley, Odetta can be contacted via phone (912) 304-3051.

Contact Information

Primary practice address
185 Richard Davis Dr Ste 102 Richmond Hill GA 31324-3978
Phone: (912) 304-3051
Fax: (844) 904-0927
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 507430
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC004492 Georgia

Profile Details

NPI number 1194082818
LBN Legal business name Smiley, Odetta
Credentials PSYD, LPC, CCMHC,MAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2012
Last updated Jan 26th, 2024 - about 11 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194082818 NPPES
Georgia Other 1194082818 NPI
Georgia MEDICAID 003228219A NPI
Georgia Other 1659911063 NPI

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