Kristen Smith, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

14790 Issued in NC

Practice address

115 Kildaire Park Dr Ste 313
Cary, NC 27518-8144

Phone

(919) 600-4906

NPI assigned

Apr 22, 2019

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

State licenses

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 and National Provider Directory roles.

• Etheridge Psychology, P.a.

  • Psychologist
  • Cary, NC
  • NPI 1275820144
  NPD

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1104489533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 SE CARY PKWY STE 201",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187413",
            "telephone_number": "919-600-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 KILDAIRE PARK DR STE 313",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188144",
            "telephone_number": "919-600-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTEN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason D. Smith, M.ED., LCMHCA
• Jennifer Kroohs Smith, MA, CCC-SLP
• Julia Marie Smith, LCSW
• Karen K Smith, DPT
• Kelly Lorriane Smith, FNP-BC
• Kristy K Smith, M.S.W.
• Lauren Nicole Smith, PA
• Lindsay Erin Smith, PTA
• Lorraine J Smith, MS: SLP
• Mandy Marie Smith

• Mental Health Counselor in Cary, NC
• Providers in Cary, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.