Jessica Lynn Smith, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2659 Issued in MN

Practice address

44 Good Counsel Dr
Mankato, MN 56001-6599

Phone

(800) 438-1772

Fax

(262) 345-5562

NPI assigned

Mar 8, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Breaking Forth Counseling LLC

  • Marriage & Family Therapist
  • North Mankato, MN
  • NPI 1740133891
  NPD Authorized official
• Wisconsin Lutheran Child & Family Service, Inc

  • Clinical Psychologist
  • Mankato, MN
  • NPI 1669758520
  NPD (past)
• Wisconsin Lutheran Child and Family Service Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Germantown, WI
  • NPI 1083786628
  NPD (past)

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1275831786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226511",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 GOOD COUNSEL DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016599",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275831786",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "39-1047224",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alanna Smith, OTD
• Anita Linnea Smith, MS, LPC, NCC
• Carolyn Smith
• Charles Smith
• Jenna Smith
• Jessica Sky Smith, LICSW
• Rebecca Lynne Smith
• Ruth Esther Smith, MD
• Thomas Smyth, D.D.S.
• Kailyn Victoria Snodgrass, BS

• Marriage & Family Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.