Kimmie C Smith

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KIMMIE C SMITH

Doing business as

SEAK Behavioral Health & Addiction Services

Practice address

817 Zimovia Highway
Apt 3
Wrangell, AK 99929

Phone

(907) 305-0985

NPI assigned

Aug 10, 2022

Last updated

Jan 25, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

KIMMIE C SMITHAs reported in NPPES

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

Authorized official

Name

Kimmie C Smith, LPCNPI 1649578204

Title

Chief Executive Officer

Phone

(907) 305-0985

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SEAK Behavioral Health & Addiction Services Doing business as

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Part of

Kimmie C Smith

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimmie Smith, MS

  • Professional Counselor
  • Wrangell, AK
  • NPI 1649578204
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1255069084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 644",
            "city": "WRANGELL",
            "state": "AK",
            "postal_code": "999290644",
            "telephone_number": "907-305-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 ZIMOVIA HIGHWAY",
            "address_2": "APT 3",
            "city": "WRANGELL",
            "state": "AK",
            "postal_code": "99929",
            "telephone_number": "907-305-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMMIE C SMITH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIMMIE C SMITH",
        "enumeration_date": "2022-08-10",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KIMMIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "907-305-0985",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1717330",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEAK Behavioral Health & Addiction Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristina Johnson
• Ian M Jones
• Scott Kallek
• Shawn Kangro
• Ursula Celeste Kilbridge
• Rumi Kodama
• Louis-Eric Lemire
• Joshua Lund
• James Maes
• Valerie Massie

• Mental Health Clinic/Center (Including Community Mental Health Center) in Wrangell, AK
• Providers in Wrangell, AK by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.