Edward Thomas Smith, MA, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

31609 Issued in CA

Practice address

210 N Pass Ave Ste 203
Burbank, CA 91505-3936

Phone

(818) 288-3644

NPI assigned

Jul 11, 2006

Sex

Male

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

Credentials

Master of Arts

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174558290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 N ROSE ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915052410",
            "telephone_number": "818-848-2989",
            "fax_number": "818-848-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N PASS AVE STE 203",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915053936",
            "telephone_number": "818-288-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "31609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexus Smith
• Arieanna Smith
• Cheyenne Smith
• Claire Smith
• Dezjaney Smith
• Morgan Smith
• Rees A Smith, D.D.S.
• Samantha Smith
• Stephen J. Smith, PSY.D.
• Taylor Smith

• Mental Health Counselor in Burbank, CA
• Providers in Burbank, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.