Individual provider Active NPI

Michelle Smith, BA

  • Mental Health Counselor
  • Manchester, NH
National Provider Identifier
1174002489
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2 Wall St Ste 300
Manchester, NH 03101-1518
Phone
(603) 668-4111
Fax
(603) 628-7757
NPI assigned
Aug 8, 2018
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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 Primary

Addresses

Primary practice location

2 Wall St Ste 300
Manchester, NH 03101-1518

Mailing address

2 Wall St Ste 300
Manchester, NH 03101-1518
Phone (603) 668-4111

Other names 1

  • Michelle Fairfield Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321002950 MD Practitioner - Clinical Social Worker 5395182653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Valley Therapy, L.L.C.Group PAC ID 1850738493, 6 clinicians

Practice addresses (Care Compare)

4 W Main St
New Market, MD 21774-6290
Phone (301) 381-4586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Therapy, L.L.C. Mental Health CurrentSince Feb 1, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1174002489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111",
            "fax_number": "603-628-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHELLE",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "FAIRFIELD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.