Jacquline Gail Smythe, MFC 43231

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 43231 Issued in CA

Practice address

55 1St St # 305I
Lakeport, CA 95453-4839

Phone

(707) 349-2586

Fax

(707) 274-9192

NPI assigned

Dec 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jacquline Smythe

  • Community/Behavioral Health Agency
  • Lakeport, CA
  • NPI 1023319241
  NPD (past) Authorized official

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1265591085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3542 CRESTWOOD DR",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518602",
            "telephone_number": "707-349-2586",
            "fax_number": "707-263-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 1ST ST # 305I",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534839",
            "telephone_number": "707-349-2586",
            "fax_number": "707-274-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTHE",
        "first_name": "JACQULINE",
        "middle_name": "GAIL",
        "name_prefix": "Mrs.",
        "credential": "MFC 43231",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 43231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265591085",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheldon King Sloan, PA-C
• Monnie Marie Smevold
• Erik Kristopher Smith, PA-C
• Jennifer Stolworthy Smith
• Amanda L Smithers, PA-C
• Nardia Sokol, DPM
• Hailey Brooke Sommerfeld
• Beverly A Southerland, P.A.
• Judy Wolfe Spillane, PH.D.
• Jennifer Marie Stabiner

• Marriage & Family Therapist in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.