Individual provider Active NPI

William Patrick Smith, M.A., J.D. L.P.C.

  • Professional Counselor
  • Shaker Heights, OH
National Provider Identifier
1255503678
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C. 0006844 Issued in OH
Practice address
3598 Glencairn Rd
Shaker Heights, OH 44122-5059
Phone
(216) 789-1978
NPI assigned
Mar 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C. 0006844 OH Primary

Addresses

Primary practice location

3598 Glencairn Rd
Shaker Heights, OH 44122-5059

Mailing address

3598 Glencairn Rd
Shaker Heights, OH 44122-5059
Phone (216) 789-1978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821003778 OH Practitioner - Mental Health Counselor 9133667116 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C. 0006844OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc. Current Accepting new patients
Signature Health Inc CurrentSince Jun 3, 2024 Accepting new patients
Signature Health, Inc CurrentSince Jun 3, 2024 Accepting new patients

Locations

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

38882 Mentor Ave
Willoughby, OH 44094

Organizations & group practices 3

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": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1255503678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3598 GLENCAIRN RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225059",
            "telephone_number": "216-789-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3598 GLENCAIRN RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225059",
            "telephone_number": "216-789-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "M.A., J.D. L.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C. 0006844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

Verify at the official NPI Registry.