Individual provider Active NPI

Ruth Ellen Smith, LPCC

  • Mental Health Counselor
  • Rochester, MN
National Provider Identifier
1265215966
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03976 Issued in MN
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

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 LTDGroup PAC ID 6406752492, 590 clinicians

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

LicenseStateTypeSpecialty
CC03976MNMDMental Health Counselor
3976MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD CurrentSince Jan 1, 2024 Accepting new patients
Family Support Services Inc. Mental Health PastSince Aug 27, 2023 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

Verify at the official NPI Registry.