Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1548747181 Individual Practitioner Female Practitioner

Dr. Shannon Marie Smith , PhD

Psychologist • Winter Haven, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Shannon Smith, PhD is a certified Psychologist practicing in Winter Haven, FL. With approximately 9 years of clinical experience since completing medical education in 2017, Dr. Smith delivers high-quality medical care to the local community at 1201 1ST ST S STE 100A.

Dr. Smith is affiliated with Kevin M. Kindelan, Ph.D. And Associates, P.A. and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1201 1st St S Ste 100a

Winter Haven, FL 338803904

Telephone 8632806080
Fax 8632297587
Associated Practice Facility / Clinic
🏢 Baycare Medical Group Inc Facility NPI 1255904413

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Winter Haven, FL

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
9 Yrs -6.8 yrs vs City Avg
City Avg: 15.8 Yrs
State Avg: 25.8 Yrs
Regional Practice Density
12 Specialists

Practicing in Winter Haven, FL (2327 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Smith (9 Years) 9 Yrs
Winter Haven Specialty Average (15.8 Years) 15.8 Yrs

Medical Specialties & State Licenses

CMS Verified: 2021-03-25
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License FL PY10219

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.

Hospital & Practice Group Affiliations

Kevin M. Kindelan, Ph.d. And Associates, P.a.

2320 Commerce Point Dr, Lakeland, FL 338016880

Phone: 8638771855

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Dr. Jared Larkin , DO

Student in an Organized Health Care Education/Training Program

NPI 1003669342

Doctor of Osteopathic Medicine (D.O.)

Madison Millikin

Student in an Organized Health Care Education/Training Program

NPI 1043150212
NPI 1053940239

Doctor of Medicine (M.D.)

Rachel Utter

Student in an Organized Health Care Education/Training Program

NPI 1063215564
Dr. Christina Rolquin , MD

Student in an Organized Health Care Education/Training Program

NPI 1073315339

Doctor of Medicine (M.D.)

Dr. Duaa Malik , MD

Student in an Organized Health Care Education/Training Program

NPI 1144023664

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location December 07, 2020

Registered at 1201 1ST ST S STE 100A, WINTER HAVEN, FL 338803904 (Tel: 8632806080)

📍
Updated Business Mailing Address December 07, 2020

Registered at 2995 DREW ST FL 2, CLEARWATER, FL 337593012 (Tel: 7275321355)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 07, 2020

Psychologist (License #PY10219 in FL)

NPI Profile Active July 26, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location July 26, 2018

Registered at 146 2ND ST N STE 305, SAINT PETERSBURG, FL 337013361 (Tel: 7273081180)

📍
Updated Business Mailing Address July 26, 2018

Registered at 146 2ND ST N STE 305, SAINT PETERSBURG, FL 337013361 (Tel: 7273081180)

👤
Provider Name / Credentials Updated July 26, 2018

Recorded as SHANNON SMITH, PH.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2018

Psychologist

🟢
Initial NPI Registration & Enumeration July 26, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1548747181
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 26, 2018
Last Update: March 25, 2021
Sole Proprietor: No

Mailing Address

2995 Drew St Fl 2

Clearwater, FL 337593012

Phone: 7275321355

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.