Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kevin Etwood Smith Jr.

Individual provider Community/Behavioral Health Agency · NPI 1790529923

Mr. Kevin Etwood Smith Jr. is a Community/Behavioral Health Agency in Gilbert, Arizona. Practices as a sole proprietor and works from 2 locations. Licensed in Arizona.

Licensed in
AZ
In the registry since
2024
Specialties on file
4

Practice location Address checks out

929 N Val Vista Dr Ste 109
Gilbert, AZ 85234-3701
Phone: (480) 862-3648
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1390 E Jasper Dr, Gilbert, AZ 85296-4347 — (480) 862-3648

Specialties & licences

Developmental Disabilities Clinic/Center (primary) Taxonomy 261QD1600X (AZ)
Community/Behavioral Health Agency Taxonomy 251S00000X (AZ)
Adult Day Care Clinic/Center Taxonomy 261QA0600X (AZ)
Assisted Living Facility Taxonomy 310400000X (AZ)

Record details

NPI number1790529923
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 21, 2024
Last updated in NPPESAugust 5, 2025
Certification dateAugust 5, 2025

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