Provider Demographics
NPI:1427691666
Name:SMITH, MARION ANITA (MA, LLPC)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:ANITA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61899M-43 PO BOX 179, VAN BURTEN COMMUNITY MENTAL HEALT
Mailing Address - Street 2:
Mailing Address - City:BANGER
Mailing Address - State:MI
Mailing Address - Zip Code:49013
Mailing Address - Country:US
Mailing Address - Phone:269-427-5671
Mailing Address - Fax:269-427-1012
Practice Address - Street 1:801 HAZEN ST # C PO BOX 249
Practice Address - Street 2:
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079
Practice Address - Country:US
Practice Address - Phone:269-657-5574
Practice Address - Fax:269-652-3474
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024363101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator