Individual provider Active NPI

Tammy S Smith

  • Mental Health Counselor
  • Cambridge, MA
National Provider Identifier
1124385612
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7359 Issued in MA
Practice address
875 Massachusetts Ave
25
Cambridge, MA 02139-3067
Phone
(781) 832-0113
NPI assigned
Apr 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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 7359 MA Primary

Addresses

Primary practice location

875 Massachusetts Ave
25
Cambridge, MA 02139-3067

Mailing address

875 Massachusetts Ave
25
Cambridge, MA 02139-3067
Phone (781) 832-0113

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

State licenses

LicenseStateTypeSpecialty
7359MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1124385612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE",
            "address_2": "25",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393067",
            "telephone_number": "781-832-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE",
            "address_2": "25",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393067",
            "telephone_number": "781-832-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAMMY",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "7359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.