Crystal Renee Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2109 S Highway 69
Wagoner, OK 74467-9310

Phone

(918) 640-0199

Fax

(918) 756-2126

NPI assigned

Oct 25, 2010

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

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1134429194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 S HIGHWAY 69",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744679310",
            "telephone_number": "918-640-0199",
            "fax_number": "918-756-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 S HIGHWAY 69",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744679310",
            "telephone_number": "918-640-0199",
            "fax_number": "918-756-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRYSTAL",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Sherman
• Zona Marie Siler
• Marissa Sinclair
• Melissa Slape, MSW U/S
• Tarek Sleem
• Florence V Smith
• Jeffrey Dale Smith
• Lisa Smith
• Kimberlie Smothermon
• Susan Solano

• Mental Health Counselor in Wagoner, OK
• Providers in Wagoner, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.