Lisa A Smith, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

120 Street a Ste C
Picayune, MS 39466-6303

Phone

(601) 569-5311

NPI assigned

Feb 10, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Gulf Coast Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gulfport, MS
  • NPI 1417934175
  NPD (past)

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1104285733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 STREET A STE C",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394666303",
            "telephone_number": "601-569-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 STREET A STE C",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394666303",
            "telephone_number": "601-569-5311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 Davis Rd",
            "address_purpose": "LOCATION",
            "city": "Picayune",
            "state": "MS",
            "postal_code": "394667451",
            "country_code": "US",
            "telephone_number": "228-209-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Zane Slade
• Karly Mitchell Slade, COTA/L
• Shannon Elaine Slizoski, LMFT
• Antonio D Smith
• Holly R Smith, LCSW
• Penelope Smith, LMT
• Christopher L Sones, NP-C
• Southern Bone & Joint Specialists, PA
• Southern Physical Therapy Clinic, Inc.
• Southern Prosthetic Care LLC

• Professional Counselor in Picayune, MS
• Providers in Picayune, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.