Individual provider Active NPI

Skylar Wyatt Smith, LPC

  • Professional Counselor
  • Harrisburg, PA
National Provider Identifier
1275767170
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC007713 Issued in PA
Practice address
1323 N Front St
Harrisburg, PA 17102-2629
Phone
(717) 917-8693
Fax
(717) 589-9901
NPI assigned
May 6, 2009
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC007713 PA Primary

Addresses

Primary practice location

1323 N Front St
Harrisburg, PA 17102-2629

Mailing address

4212 Ridge Dr
Harrisburg, PA 17109-4337
Phone (717) 917-8693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241227001971 PA Practitioner - Mental Health Counselor 6507393808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC007713PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Welcoming Connections, LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

1323 N Front St
Harrisburg, PA 17102
Phone (717) 917-8693

Organizations & group practices 1

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": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1275767170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 RIDGE DR",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094337",
            "telephone_number": "717-917-8693",
            "fax_number": "717-589-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 N FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171022629",
            "telephone_number": "717-917-8693",
            "fax_number": "717-589-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SKYLAR",
        "middle_name": "WYATT",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2009-05-06",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC007713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.