Shannon Leigh Smith Reedy, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A19475 Issued in NC

Practice address

753 S. Main Street
Raeford, NC 28376

Phone

(910) 490-2037

Fax

(910) 479-1711

NPI assigned

May 10, 2023

Last updated

Dec 12, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1275223596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15961 FOX LN",
            "city": "WAGRAM",
            "state": "NC",
            "postal_code": "283969740",
            "telephone_number": "910-992-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 S. MAIN STREET",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "28376",
            "telephone_number": "910-490-2037",
            "fax_number": "910-479-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDY",
        "first_name": "SHANNON",
        "middle_name": "LEIGH SMITH",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A19475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.