Active NPI
Debra L Smith, LPC
- Professional Counselor
- Springfield, IL
National Provider Identifier
1184175341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178011918
- Practice address
- 5230 S 6TH Street Rd
Springfield, IL 62703-5128 - Phone
- (217) 585-1180
- Fax
- (217) 585-4747
- NPI assigned
- Oct 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178011918 | IL | Primary |
Addresses
Primary practice location
5230 S 6TH Street Rd
Springfield, IL 62703-5128
Mailing address
5230 S 6TH Street Rd
Springfield, IL 62703-5128
Phone (217) 585-1180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178011918 | Other | IL | LICENSED PROFESSIONAL COUNSELOR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178011918 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1184175341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5230 S 6TH STREET RD",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627035128",
"telephone_number": "217-585-1180",
"fax_number": "217-585-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5230 S 6TH STREET RD",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627035128",
"telephone_number": "217-585-1180",
"fax_number": "217-585-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DEBRA",
"middle_name": "L",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-21",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178011918",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PROFESSIONAL COUNSELOR",
"identifier": "178011918",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.