Individual provider Active NPI

Ann Smith, LPC

  • Mental Health Counselor
  • Little Rock, AR
National Provider Identifier
1104200328
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P2008069 Issued in AR
Practice address
6601 West 12TH Street
Little Rock, AR 72204-1513
Phone
(501) 666-8686
Fax
(501) 660-6829
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P2008069 AR Primary

Addresses

Primary practice location

6601 West 12TH Street
Little Rock, AR 72204-1513

Mailing address

P.O. Box 251970
Little Rock, AR 72225-1973
Phone (501) 666-8686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20240715000578 AR Practitioner - Mental Health Counselor 8628513686 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Youth and Families, Inc. CurrentSince Jun 4, 2024 Accepting new patients
Youth Home Inc PastSince Sep 20, 2017 Accepting new patients

Locations

5800 W 10th St
Ste 101
Little Rock, AR 72204
Phone (501) 660-6886

6601 W 12th St
Little Rock, AR 72204
Phone (501) 660-6821

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youthhome/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1104200328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 251970",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722251973",
            "telephone_number": "501-666-8686",
            "fax_number": "501-660-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 WEST 12TH STREET",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041513",
            "telephone_number": "501-666-8686",
            "fax_number": "501-660-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2024-05-29",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2008069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.