Jeremiah T Smith, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2303580-SUPV Issued in OH

Practice address

4269 Pearl Rd FL 3
Cleveland, OH 44109-4234

Phone

(216) 431-4131

NPI assigned

Feb 27, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, PA2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindfully LLCGroup PAC ID 3476606252, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindfully, LLC

  • Counselor
  • Fairfield, OH
  • NPI 1972702520
  Medicare reassignment Care Compare group NPD
• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713
  Medicare reassignment NPD
• The Metrohealth System

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1053353896
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  OH, PA, Professional

  Medicare reassignment NPD
• The Metrohealth System

  • Pharmacy
  • Cleveland, OH
  • NPI 1992529911
  NPD
• Mindfully, LLC

  • Counselor
  • Jacksonville, FL
  • NPI 1376271981
  NPD
• Mindfully Psychiatry LLC

  • Psychiatry Physician
  • Montgomery, OH
  • NPI 1881341543
  NPD (past)

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1063046043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4269 PEARL RD FL 3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094234",
            "telephone_number": "216-431-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4269 PEARL RD FL 3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094234",
            "telephone_number": "216-431-4131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1251 Nilles Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "OH",
            "postal_code": "450147205",
            "country_code": "US",
            "telephone_number": "513-939-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEREMIAH",
        "middle_name": "T",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-27",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2303580-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janett Smith
• Januari Smith
• Jean Lynn Smith
• Jeanine Marie Smith
• Jennifer Lynne Smith, CNP
• Jeri Nanette Smith
• Jessica Lynn Smith
• Jeter Smith
• Joel Kevin Smith
• Joelle Kay Smith

• Professional Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.