Active NPI
Jo Ann Smith, M.ED., LPC
- Mental Health Counselor
- Van Buren, AR
National Provider Identifier
1104832153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P9408023
- Practice address
- 3111 South 70TH Street
Van Buren, AR 72956-1944 - Phone
- (479) 444-5048
- Fax
- (479) 444-5039
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P9408023 | AR | Primary |
Addresses
Primary practice location
3111 South 70TH Street
Van Buren, AR 72956-1944
Mailing address
106 Azure Hills Dr
Van Buren, AR 72956-2214
Phone (479) 422-3119
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P9408023 | Other | AR | LICENSED PROR. COUNSELOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P9408023 | AR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234396800000",
"number": "1104832153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 AZURE HILLS DR",
"city": "VAN BUREN",
"state": "AR",
"postal_code": "729562214",
"telephone_number": "479-422-3119",
"fax_number": "479-452-5847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 SOUTH 70TH STREET",
"city": "VAN BUREN",
"state": "AR",
"postal_code": "729561944",
"telephone_number": "479-444-5048",
"fax_number": "479-444-5039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JO",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "M.ED., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2009-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "P9408023",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PROR. COUNSELOR",
"identifier": "P9408023",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Van Buren, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.