Jackie Small, MA, LPC, CLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3158 Issued in CT

Practice address

1 Turkey Hill Rd S
Suite 2L
Westport, CT 06880-5525

Phone

(646) 246-7379

NPI assigned

Aug 28, 2014

Last updated

Mar 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1093115974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TURKEY HILL RD S",
            "address_2": "SUITE 2L",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TURKEY HILL RD S",
            "address_2": "SUITE 2L",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805525",
            "telephone_number": "646-246-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "JACKIE",
        "credential": "MA, LPC, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3158",
            "primary": true
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CT",
            "license": "ALPP-203587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maria Slowik
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• Abigail J Smith, DPT
• Annie Belle Smith, L.C.S.W.
• Loren A Smith, LMFT
• Thomas Edward Smith, M.D.

• Professional Counselor in Westport, CT
• Providers in Westport, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.