Individual provider Active NPI

Victoria Anne Smith

  • Mental Health Counselor
  • Peachtree City, GA
National Provider Identifier
1194692483
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
APC010711 Issued in GA
Practice address
302 Stevens Entry
Peachtree City, GA 30269-1325
Phone
(770) 486-4887
NPI assigned
Oct 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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 APC010711 GA Primary

Addresses

Primary practice location

302 Stevens Entry
Peachtree City, GA 30269-1325

Mailing address

302 Stevens Entry
Peachtree City, GA 30269-1325
Phone (770) 486-4887

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

LicenseStateTypeSpecialty
APC010711GAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Life Change Group PastSince Nov 7, 2025 Accepting new patients
Woven Paths Counseling LLC PastSince Nov 7, 2025 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1194692483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 STEVENS ENTRY",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691325",
            "telephone_number": "770-486-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 STEVENS ENTRY",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691325",
            "telephone_number": "770-486-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICTORIA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC010711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.