Linda R Smith, OFFICIAL AGENT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L000000036622 Issued in TN

Practice address

1324 Trotwood Ave Ste 11
Columbia, TN 38401-4750

Phone

(931) 215-2182

Fax

(931) 381-5363

NPI assigned

Jan 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Linda R Smith Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Legacy Life Care Programs

  • Community/Behavioral Health Agency
  • Columbia, TN
  • NPI 1962746842

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1225450802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BIGBY DR",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014704",
            "telephone_number": "931-215-2182",
            "fax_number": "931-381-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 TROTWOOD AVE STE 11",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014750",
            "telephone_number": "931-215-2182",
            "fax_number": "931-381-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LINDA",
        "middle_name": "R",
        "credential": "OFFICIAL AGENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2025-02-19",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "TNMFT-1814",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "L000000036622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962746842",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGACY LIFE CARE PROGRAMS-OUTPATIENT MENTAL HEALTH AGENCY LICENSE",
            "identifier": "L000000036622",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0006613",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "legacyoflife16@yahoo.com",
            "affiliation": "Y",
            "endpointDescription": "Company email",
            "affiliationName": "Legacy Life Care Programs 501 c 3 Corporation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N Bigby Dr",
            "city": "Columbia",
            "state": "TN",
            "country_code": "US",
            "postal_code": "384014704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "SMITH",
            "middle_name": "R",
            "credential": "OFFICER AGENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hudson Smith
• Jacqueline Rena Smith, APRN, BC
• Jaime Smith
• Lang Smith
• Lauren Smith, RN
• Marvin Montgomery Smith, M.D.
• Megan Leigh Smith
• Richard P Smith, M.D.
• Shannon Smith, L.P.C.
• Steven C Smith, MD

• Mental Health Counselor in Columbia, TN
• Providers in Columbia, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.