Individual provider Active NPI

Jo Ann Smith, M.ED., LPC

  • Mental Health Counselor
  • Van Buren, AR
National Provider Identifier
1104832153
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P9408023 Issued in AR
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

Updated by the provider on Feb 12, 2009

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 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

IdentifierTypeStateIssuer
P9408023OtherARLICENSED 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

LicenseStateTypeSpecialty
P9408023ARMDMental 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.

Verify at the official NPI Registry.