Active NPI
Kelli Smith, MC61336785
- Mental Health Counselor
- Oakville, WA
National Provider Identifier
1083349054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61336785
- Practice address
- 420 Howanut Rd
Oakville, WA 98568-9659 - Phone
- (360) 709-1733
- NPI assigned
- Jul 22, 2022
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC61336785 | WA | Primary |
Addresses
Primary practice location
420 Howanut Rd
Oakville, WA 98568-9659
Mailing address
PO Box 508
Oakville, WA 98568-0508
Phone (360) 709-1733
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 |
|---|---|---|---|
| MC61336785 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1083349054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 508",
"city": "OAKVILLE",
"state": "WA",
"postal_code": "985680508",
"telephone_number": "360-709-1733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 HOWANUT RD",
"city": "OAKVILLE",
"state": "WA",
"postal_code": "985689659",
"telephone_number": "360-709-1733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KELLI",
"credential": "MC61336785",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-22",
"last_updated": "2022-07-22",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61336785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakville, WA
- Panoptic Speech Therapy Services, PLLC
- Steven Dean Penney, CDP
- Barbara Sanders, LMP, LMHC
- Jessica Simmons, FNP
- Gary Scott Sims, S.U.D.P.
- Lisa Lea Stephens, MA CCC-SLP
- The Chehalis Tribal Health & Wellness Center
- The Chehalis Tribal Health & Wellness Center
- The Chehalis Tribal Health Center
- Unified Health Care, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.