Active NPI
Mary F Smith, LPC-S, LMFT
- Professional Counselor
- Ponchatoula, LA
National Provider Identifier
1124531397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2724
- Practice address
- 100 N 13TH St
Ponchatoula, LA 70454 - Phone
- (985) 517-7034
- NPI assigned
- Nov 9, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 851 | LA | |
| Professional Counselor | 101YP2500X | 2724 | LA | Primary |
Addresses
Primary practice location
100 N 13TH St
Ponchatoula, LA 70454
Mailing address
100 N 13TH St
Ponchatoula, LA 70454
Phone (985) 517-7034
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972911345 | Other | ORGANIZATIONAL NPI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Ponchatoula | Other |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 851 | LA | MD | Marriage & Family Therapist |
| 2724 | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1124531397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N 13TH ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "70454",
"telephone_number": "985-517-7034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N 13TH ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "70454",
"telephone_number": "985-517-7034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MARY",
"middle_name": "F",
"name_prefix": "Mrs.",
"credential": "LPC-S, LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-09",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "LA",
"license": "851",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "2724",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ORGANIZATIONAL NPI",
"identifier": "1972911345",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Ponchatoula",
"affiliation": "N",
"endpointDescription": "Teletherapy",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Ponchatoula",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Ponchatoula",
"address_1": "100 N 13th St",
"city": "Ponchatoula",
"state": "LA",
"country_code": "US",
"postal_code": "70454",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.