Individual provider Active NPI

Meiline Smith

  • Marriage & Family Therapist
  • Enfield, CT
National Provider Identifier
1013436336
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
153 Hazard Ave
Enfield, CT 06082-4592
Phone
(860) 253-5020
Fax
(860) 253-5030
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

153 Hazard Ave
Enfield, CT 06082-4592

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1587
Phone (860) 731-5522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260615003550 CT Practitioner - Marriage and Family Therapist 3678946712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

171 Market SQ
Newington, CT 06111-2927

1929 Baltimore Reynoldsburg Rd
Unit 522
Reynoldsburg, OH 43068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Mental Health Solutions, LLC CurrentSince Aug 16, 2020 Accepting new patients

Locations

171 Market Sq
Newington, CT 06111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1013436336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951587",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824592",
            "telephone_number": "860-253-5020",
            "fax_number": "860-253-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MEILINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.