Lisa Smith, LICDC, SAP, LPC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

111024 Issued in OH

Practice address

4100 Franklin Blvd
Cleveland, OH 44113-2842

Phone

(216) 623-0959

NPI assigned

May 19, 2015

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

• Lutheran Metropolitan Ministry

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
  • NPI 1659839041
  Authorized official Same address or phone

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1255710570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16908 WALDEN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441281542",
            "telephone_number": "216-246-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 FRANKLIN BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132842",
            "telephone_number": "216-623-0959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16908 Walden Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441281542",
            "country_code": "US",
            "telephone_number": "216-246-2944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "LICDC, SAP, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "111024",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2003026",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OH",
            "license": "OCPC.1222",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206488",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lavedia Smith, RN
• Leah Smith
• Lenette Smith
• Leslie Smith, C-CHW, QMHS
• Lillian Smith
• Lisa J Smith, CNP, WHNP, MSN
• Lloyd Smith
• Maia A Smith
• Makanya Latasha Sarvera Smith
• Makayla Taylor Smith, DPT

• Addiction (Substance Use Disorder) Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.