Marissa Viola Smith, MA, LPC, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0014671 Issued in CO

Practice address

11001 W 120TH Ave Ste 200
Broomfield, CO 80021-3493

Phone

(720) 319-7468

NPI assigned

Jun 8, 2017

Last updated

Jun 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Heartwood Counseling Services, LLC

  • Mental Health Counselor
  • Broomfield, CO
  • NPI 1962141291
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1093244485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 W 120TH AVE STE 200",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213493",
            "telephone_number": "720-319-7468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 W 120TH AVE STE 200",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800213493",
            "telephone_number": "720-319-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARISSA",
        "middle_name": "VIOLA",
        "credential": "MA, LPC, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0014671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Tovar Smith
• Jaime E Smith, LCSW
• Jennifer Smith
• Mackenzie Lee Smith
• Mandi Marie Smith
• Sara Keyser Smith
• Savannah Smith
• Stacey Amanda Smith, PHARMD
• SNS Technical Services, LLC
• Randy Bruce Snyder, DC

• Professional Counselor in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.