Fillmore Lewis Smiley IV, LPCC, LAADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

23646 Issued in CA

Practice address

32075 Pine Cone Drive
Running Springs, CA 92382-1578

Phone

(909) 301-0011

NPI assigned

Oct 9, 2015

Last updated

Sep 28, 2026By the provider in NPPES

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

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1184095663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1578",
            "city": "RUNNING SPRINGS",
            "state": "CA",
            "postal_code": "923821578",
            "telephone_number": "909-301-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32075 PINE CONE DRIVE",
            "city": "RUNNING SPRINGS",
            "state": "CA",
            "postal_code": "923821578",
            "telephone_number": "909-301-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "FILLMORE",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "LPCC, LAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "23646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pine Ridge Treatment Centers, Inc.
• Jason Dennis Rezansoff, D.C.
• Judith Eileen Rossbach, LCSW
• Running Springs Water District (Running Springs Fire Department)
• San Bernardino Mountains Community Hospital District (Running Springs Rural Health Clinic)
• Claire St John, RD
• Kayla Vadurro
• Enid A Velasco

• Professional Counselor in Running Springs, CA
• Providers in Running Springs, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; 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.