Active NPI
Reesa Smith, LMFT
- Marriage & Family Therapist
- Fortville, IN
National Provider Identifier
1013409994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35002048A
- Practice address
- 412 S. Maple St.
Suite 100B
Fortville, IN 46040 - Phone
- (765) 276-7131
- NPI assigned
- Jun 5, 2018
- Last updated
- Jan 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35002048A | IN | Primary |
Addresses
Primary practice location
412 S. Maple St.
Suite 100B
Fortville, IN 46040
Mailing address
9249 W Swimming Hole LN
Pendleton, IN 46064-8659
Phone (765) 610-9864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35002048A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610928000000",
"number": "1013409994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9249 W SWIMMING HOLE LN",
"city": "PENDLETON",
"state": "IN",
"postal_code": "460648659",
"telephone_number": "765-610-9864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 S. MAPLE ST.",
"address_2": "SUITE 100B",
"city": "FORTVILLE",
"state": "IN",
"postal_code": "46040",
"telephone_number": "765-276-7131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "REESA",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-05",
"last_updated": "2021-01-18",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35002048A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fortville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.