Marcus Lacey Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005367 Issued in NY

Practice address

1106 E Genesee St
Syracuse, NY 13210-1901

Phone

(315) 391-8482

NPI assigned

Oct 28, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1083378764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101901",
            "telephone_number": "315-391-8482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Wilson Pl",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132141924",
            "country_code": "US",
            "telephone_number": "315-391-8482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARCUS",
        "middle_name": "LACEY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "005367",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BCBS",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1106 E Genesee St",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyle Alan Smith
• Laurie G Smith, SLP
• Leigh C Smith, M.S. CCC-SLP
• Lisa Ann Smith, MSOTR/L
• Madalyn Frances Smith, LCSW
• Marissa M Smith, MD
• Michelle Catherine Smith, LMSW-C
• Niosha Terea Smith, LPN
• Patrick B Smith, DDS
• Roshoda Takeema Tashiana Smith

• Mental Health Counselor in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.