John Smith, MA LPC CRC SCL

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401005523 Issued in MI

Practice address

9315 Telegraph Rd
Redford, MI 48239-1260

Phone

(313) 450-4500

NPI assigned

Oct 30, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1184029340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 COLRAIN DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283618",
            "telephone_number": "248-738-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391260",
            "telephone_number": "313-450-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2775 Colrain Dr",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483283618",
            "country_code": "US",
            "telephone_number": "248-738-6646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "credential": "MA LPC CRC SCL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-30",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "00014088",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MI",
            "license": "MI-SC0000000749838",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401005523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anitra Shawnta Smith, LLMSW
• Clark K Smith, D.D.S.
• Elizabeth Smith, LLMSW
• Idell Smith, MSW
• Jessica Lauren Smith, RN
• Sarah Alice Smith, CPSS
• Thoshia Evette Smith, CPSS
• Anne E Snudden, M.A., IMH-E(III)
• Chanel Denise Somerville, RN. BSN
• Janel Marie Sonnenberg

• Professional Counselor in Redford, MI
• Providers in Redford, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.