Individual provider Active NPI

Christina L Smith

  • Mental Health Counselor
  • Wilton Manors, FL
National Provider Identifier
1164761532
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2848 NE 17TH Ter
Wilton Manors, FL 33334
Phone
(954) 401-9377
NPI assigned
Feb 5, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 NU Primary

Addresses

Primary practice location

2848 NE 17TH Ter
Wilton Manors, FL 33334

Mailing address

2848 NE 17TH Ter
Wilton Manors, FL 33334-4337
Phone (954) 401-9377

Other practice location 1

18100 SW 60th St
Southwest Ranches, FL 33331-1608
Phone (954) 401-9377

Other practice location 2

18100 SW 60th St
Southwest Ranches, FL 33331-1608
Phone (954) 401-9377

Other practice location 3

730 S Clark St
Apt. 902
Chicago, IL 60605-1743
Phone (954) 401-9377

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

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164761532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 NE 17TH TER",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333344337",
            "telephone_number": "954-401-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 NE 17TH TER",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "33334",
            "telephone_number": "954-401-9377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18100 SW 60th St",
            "address_purpose": "LOCATION",
            "city": "Southwest Ranches",
            "state": "FL",
            "postal_code": "333311608",
            "country_code": "US",
            "telephone_number": "954-401-9377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18100 SW 60th St",
            "address_purpose": "LOCATION",
            "city": "Southwest Ranches",
            "state": "FL",
            "postal_code": "333311608",
            "country_code": "US",
            "telephone_number": "954-401-9377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 S Clark St",
            "address_2": "Apt. 902",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606051743",
            "country_code": "US",
            "telephone_number": "954-401-9377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.