Active NPI
Ruth Ellen Smith, LPCC
- Mental Health Counselor
- Rochester, MN
National Provider Identifier
1265215966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC03976
- Practice address
- 401 16TH St SE Ste 100
Rochester, MN 55904-7974 - Phone
- (507) 516-0030
- Fax
- (507) 516-0031
- NPI assigned
- Aug 16, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC03976 | MN | Primary |
Addresses
Primary practice location
401 16TH St SE Ste 100
Rochester, MN 55904-7974
Mailing address
309 8TH St NW
Austin, MN 55912-2368
Phone (507) 438-6559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240212002516 | MN | Practitioner - Mental Health Counselor | 2567805013 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nystrom and Associates LTD
Practice addresses (Care Compare)
401 16TH St SE
Suite 100
Rochester, MN 55904-7974
Phone (507) 516-0030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC03976 | MN | MD | Mental Health Counselor |
| 3976 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates, LTD | Current | Accepting new patients | |
| Family Support Services Inc. | Mental Health | Past | Accepting new patients |
Locations
401 16th St SE
Ste 100
Rochester, MN 55904
Phone (507) 516-0030
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
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": "1692144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1265215966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 8TH ST NW",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559122368",
"telephone_number": "507-438-6559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 16TH ST SE STE 100",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559047974",
"telephone_number": "507-516-0030",
"fax_number": "507-516-0031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "RUTH",
"middle_name": "ELLEN",
"name_prefix": "Mrs.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-16",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "CC03976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.